The British Association of Dermatologists audit of atopic eczema management in secondary care. Phase 2: audit of service process

An audit of atopic eczema management, conducted on behalf of the British As sociation of Dermatologists, examined service structure (phase 1), process (phase 2) and outcome (phase 3). In phase 2, an on-site case-note audit was conducted in 19 hospital dermatology departments randomly selected from th e original sample of 187 centres across the U.K(. In total, 630 sets of not es were examined for completeness of: (i) information given to general prac titioners (GPs) in clinic letters and (ii) facts relevant to the management of atopic eczema recorded in the patients' notes. In general, the informat ion given to GPs in the clinic letters was good, with the recording of diag nosis, treatment and follow-up approaching the 100% working standard. Factu al information such as site and severity of eczema (83% and 74%), and prese nce or absence of asthma (53%) were better recorded than quality of life is sues such as sleep loss secondary to itching (21%) and effect on school, wo rk or social life (6%). On average, only 51% of all audit measures were rec orded across all centres, with slight variation between centres (41-61%). T he centre with the best recording had a purpose-designed data sheet for doc tors to complete when seeing new patients with atopic eczema, Such data she ets may help improve case-note recording. Similar data sheets for patients to complete may be more time-efficient.