Quality improvement in early psychosis treatment: The use of a file audit

Abstract

Background: Previous work demonstrated significant improvements in early psychosis services following staff training and service restructuring. Several aspects of care were identified for further improvement and the limitations of the file audit methodology discussed (Gorrell et al., ).

Aims: The current project aimed to: (i) Facilitate further improvement in early psychosis services through the introduction of local clinical guidelines, the provision of staff training and the provision of feedback to clinicians during the audit process. (ii) Increase the accuracy of the file audit methodology by consultation with clinicians and accessing multiple sources of information. In addition, some aspects of service provision were evaluated against preliminary benchmarks.

Method: The audit tool described by Gorrell and colleagues () was employed in this study.

Results: Significant improvements were found on nine of the aspects of service provision audited. Six of the proposed benchmarks were achieved.

Conclusion: Medical record audit proved to be a useful methodology to evaluate service provision and identify areas for quality improvement. File audit may be used to obtain a “snapshot” of service provision at regular time intervals, or to contribute to an ongoing quality improvement process in combination with other strategies.

Keywords:

• Early psychosis
• file audit
• quality improvement
• clinical guidelines