Audit in public health medicine: a draft discussion document

This discussion document, on the topic of audit in public health medicine, was developed by a sub-committee of the Research Committee of the Faculty of Public Health Medicine of the Royal College of Physicians of Ireland. The principles upon which audit in public health medicine is based include those of health gain and social gain as set out in the 1994 Department of Health strategy document, "Shaping a Healthier Future".1 Quality of care is one of the three key principles of the health strategy. The document is also underscored by Maxwell's principles of effectiveness, efficiency, equity, acceptability, appropriateness, accountability, accessibility and relevance.2 Public health doctors must apply the principles of audit to the practice of public health medicine, with the objective of implementing change and raising standards of practice. Black says that public health medicine must put its own house in order by reviewing its own performance and that to do anything less while entreating clinical colleagues to undertake quality assurance would be tactless and foolhardy.