The hospital administration and clinicians need to clarify the detail of their commitment. The difficulties inherent in medical audit are fm8legion but the aim is to evaluate the quality of medical care to maintain the standards of excellence and if possible to improve these standards that fall below the accepted level. Strong professional commitment is the key.

The need for bringing out a second edition by the author is in itself a testimony to the Healthy and application of medical audit by the clinicians. The attempt made by Dr Anajan Prakash, Addl Medical Superintendent, Dr RML Hospital is worth applauding and augurs well for the future of medical are evaluation and quality assurance. The text in this book is direct, simple and lucid. This book is comprehensive and all encompassing. Electronic health records and the increasing role of information technology have been duly incorporated.

The book is indispensable for those health care providers who are relentlessly making efforts to constantly improve the quality of care they are providing. Evaluation of care by the process of medical audit can also help in meeting the biggest challenge of lowering down the cost of various treatment modalities and making health care role efficient and vide effective.

I appreciate the work done by Dr Anjan Prakash and am confident that this book will prove to be useful to hospital administrations and clinicians. I recommend it as an essential reading for all concerned with the provision of quality health care.

This monograph on “Medical Audit” by Dr Anjan Prakash is an excellent treatise on the subject. It begins with the origins of medical fm10audit, rudiments of which are said to exist in “Charaka Samhita” and the Code of King Hammurabi of Babylon. The most recent definition and current concepts of medical audit have been extensively discussed. Quality of care, quality assurance including peer review, clinical review and utilization review have been discussed. Subjects like computers in audit, medical audit scenario in other countries and in India, issues and prerequisite components of medical audit, its educational approach and critical appraisal have been very methodically and efficiently addressed. Thoughtful and practical guidelines in relation to implementation of medical audit in the hospital have also been included. Useful questionnaires pertaining to introduction of medical audit have also been appended. The text is thoroughly updated and exhaustively referenced.

This book is a comprehensive and thorough work on the subject of medical audit. The author with her wealth of practical experience, from which a substantive amount of this material is derived, has drawn in extensively from current world literature. It is not only helpful for postgraduates and hospital administrators but also a handy reference for clinicians and other specialists working within the ambit of the hospital and outside it.

The need for the Publication of this edition in itself testifies the acceptance of the philosophy and technique of medical audit by the providers of health care. This humble book endeavors to equip the health professionals to meet the challenges present in the current scenario of delivery of care. Medical audit entails a measurement of performance and continuing evaluation stimulates improved clinical services, professional education, hospital administration and leads to better patient care. This is medical audit. The flowering of medicine through advances in scientific knowledge is evident to everyone. But the clinician must remain “a life long student” Specialization has reached such a state that the patients have to learn to diagnose themselves before they know which specialist/super specialist they should reach and the information explosion especially through the internet has made the patients and their attendants better informed, more knowledgeable and more assertive. Considering this the providers of health care need to meet the increased consumer expectation and in order to ensure the effectiveness of the hospital it becomes necessary to ensure that the levels of care are evaluated in accordance with predetermined criteria. Qualitative and quantitative assessments of medical care provided will have to be made vis-a-vis predetermined standards and criteria. However, imagination is needed in meeting the challenge that certain vital elements in the provision of care are not measurable. Delivery of clinical care is not only a scientific procedure but it is also an art and the clinician is seen as a conduit of divine grace. This assumption in the divine origin produces unshakable faith not only in the treatment but also in the provider of care. This spiritual and emotional aspect is very important to the patients and the public of our country, though commercialization has turned a lot many scales.

fm12We have had the benefit of receiving numerous letters and e-mails from the readers of the first edition and their queries and concerns have enabled me to give a more comprehensive shape to this edition. Electronic health records and the cutting-edge analytical tools of computerized hospital information management systems go a long way in facilitating the process of medical audit and hence their role has been included in this edition and we are indebted to Sh. Santulan Chaubey, Dept of IT, Govt.of NCT of Delhi for his technical inputs on the subject.

This book is meant to be a companion to the health care administrators as well as the providers of health care as an introduction to the science and art of medical audit, its proper application the associated challenges and we very humbly hope that it intellectually stimulates them enough to implement medical audit and evaluate the care being provided by them.

There could not be many changes in the text as the science and the philosophy of medical audit remains the same, however, the increasing use of information technology has added newer dimensions to the process and procedures and medical audit and hence inclusions on this have been made to make the book more comprehensive and all encompassing.

To ensure a continual improvement and to address the errors of omission or commission and shortcomings, if any suggestions are invited as they will help in substantiating the endeavour towards providing an ideal third edition.

Medical Audit is a very important regulatory mechanism which aims to raise the quality of medical care through an in-built system of peer review of professional work of the hospital by an in house committee of the medical staff. Medical Audit also helps in streamlining the procedures related to the provision of medical care by pinpointing the bottlenecks in diagnostic, therapeutic and other supportive services of the hospital. In brief, medical audit is beneficial for the patient, the medical staff and the hospital administration.

In this book, an attempt has been made to provide comprehensive information about the complex issue of medical audit which would be educational for the medical staff and beneficial for the patients. It is sincerely hoped that medical audit will not only be useful but will prove to be a milestone in improving the quality of medical care services, provided, it is implemented in its true spirit.

We also acknowledge our sincere thanks to Dr DK Sharma, Medical Superintendent and Professor, Department of Hospital Administration, AIIMS, New Delhi for his critical analysis of the contents and his advice.

We express our gratitude to Dr TS Sidhu, Medical Superintendent, Dr RML Hospital for his keenness for precision, continuous guidance and valued suggestions.

We acknowledge our debt to Dr Shakti Gupta, Professor and Head, Department of Hospital Administration, AIIMS, New Delhi for his great concern and valuable advice.

With reverence and gratitude, we acknowledge the support of our family, i.e. Aarti and Abhishek, who have smilingly given up many hours which we would have spent together—“They also serve who only stand and wait”.

Our sincerest appreciations and grateful thanks to Shri Jitendar P Vij, CMD, M/s Jaypee Brothers Medical Publishers without whose guidance and active help this book would have remained a dream. We are indebted to Mr Tarun Duneja for his constructive advice and support. His unwillingness to compromise excellence for expediency has contributed to this book in no small measure resulting in clarity and lustre as it may possess. Any deficiencies therein are ours. We acknowledge our indebtedness to Ms Samina Khan (PA to Publishing-Director) for her untiring and active support and encouragement.

Again our sincerest appreciations to all those who have helped us in the completion of this book.

I conclude hereby praying to Lord Ganesh for his blessing to enable us to acquire all the qualities so as to become a successful “Administrator”.