Medical audit_audit in hospitals and medical

The purpose of an audit is to form a view on whether the information presented in the financial report, taken as a whole, reflects the financial position of the organisation at a given date

1. AUDIT

2. •Audit is the examination or inspection of various books of
accounts by an auditor followed by physical checking of
inventory to make sure that all departments are following
documented system of recording transactions.

3. MEDICAL AUDIT
Medical auditing is a systematic performance assessment within a healthcare
organization. Most healthcare elements can be audited, but many audits look at
components of payer reimbursement processes to evaluate compliance with
payer guidelines and federal and state regulations.
Medical audit is the examination of professional dealings by clinicians & their
verification according to the standards or criteria,on the basis ofdata collected
through professional accounting system in hospitals i.e.Medical Records.

4. History of
Medical Audit

5. History of
Medical Audit

9. TYPES OF MEDICAL AUDIT:
Internal Audit (Peer Review)
Continuously byhospital staff.
Abstracting & classifying clinical record and evaluating quality of medical
care.
Review by practicing physicians.
External Audit
By outside agency.
Periodically tests completeness & accuracy of internal audit.
Review bynon-medical administrators.

10. INTERNAL AUDIT
Internal audit is an independent management function, which involves a
continuous and critical appraisal of the functioning of an entity with a
view to suggest improvements thereto and add value to and strengthen
the overall governance mechanism of the entity, including the entity’s
strategic risk management and internal control system.

11. EXTERNAL AUDIT
Anexternal auditis an independent examination or review of processes, procedures,
financial data or other aspects of an organisationconducted by an external party. This
external party may be a professional audit firm, an accounting firm or an independent audit
organisationthat has no direct connection to the organisationbeing audited. External
audits are used to verify the accuracy, correctness, legality and reliability of information,
systems or processes in an organisation. The external party performs an objective
assessment and evaluates compliance with standards, regulations, policies or procedures.

12. **To the patient:
Better care as scientific work is kept at highest plane of
efficiency.
Attending clinician leave nothing undone.
Technical staff ensures updating ofknowledge &
techniques.
Diagnostic facilities are up to highest available
standards.
In patient services ensure prevention of infection &
other morbidity.
Improvement in total care will Reduce Mortality Rate
**To the hospital:
Analysis of professional work.
Reveals weaknesses, if any.
Emphasize points of strength.
Ensures improvement in medical practice.
Administrationgets clear statements of the
results produced & can then compare with
comparable institutions.
The above self-analysis enhances reputation
ofthe hospital.

13. **To the community:
Curative–members of thecommunity find themselves
be treated in accordance with the best medical care.
Preventive-systematic examination of individuals, is
showing marked results in early diagnosis &
prevention ofdiseases
**To the clinician:
Increased clinical efficiency by the procedure of
medical audit &associated staff conferences.
Stimulus for CME.
Knowledge of newer modalities oftreatment,
variations in surgicaltechniques.
Intellectual stimulus.
Co-operation & fellowship is promoted.
Serves to rouse the clinicians to perform at his/ her
best.

14. What are theadvantagesofexternal audits?
1.Objectivity: External audits are conducted by independent organisationsor individuals who have no personal or
financial interest in the organisationbeing audited. This ensures an objective assessment as the auditors are
unbiased and have no internal conflicts of interest.
2.Credibility: External audits contribute to credibility and trust by providing independent confirmation of an
organisation'sfinancial information, internal controls or other audited aspects. Audit results are more reliable to
stakeholders and the public and provide greater assurance about the integrity and accuracy of the information.
3.Compliance with standards: External audits help organisationsensure that they comply with applicable
standards, regulations or legal requirements. This is particularly important in areas such as financial reporting,
data protection, environmental management or quality assurance. External audits can identify and correct
potential violations or non-compliance.

15. 4. Identification of risks: External audits uncover potential risks, weaknesses or deficiencies in an
organisation'sprocesses, systems or controls. This enables the organisationto identify these risks early and
take appropriate action to mitigate risks or improve processes.
5. Improving efficiency: External audits review an organisation'sexisting processes and systems. This can
help identify inefficiencies or unnecessary costs and highlight opportunities to improve efficiency and
effectiveness.
6. Promoting transparency: External audits play an important role in monitoring an organisation's
compliance with ethical standards and policies. They help prevent misconduct, fraud or unethical
behaviourand promote a culture of transparency and accountability.