Q: WHAT DO YOU LEARN WHEN YOU DO A SECOND AUDIT FIVE YEARS AFTER THE FIRST?

A team of investigators were able to compare audits on treatment for hip fractures carried out in seven hospitals in East Anglia, UK in 1992 and 1997. They found a number of changes. Pharmaceutical thromboembolic prophylaxis had gone up from 45% to 81% and early mobilisation from 56% to 70%. Cases of pneumonia, wound infection, pressure sores, and fatal pulmonary embolism had gone down. Functional outcomes (at 3 months) and mortality had not improved. Some hospitals were doing better in some areas, but others were doing worse. “This highlights the need for continuous quality improvement by repeating the audit cycle to reach and then improve standards”, write the authors. They identify rehabilitation and long term support as key …