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Medical audit in practice.

A stage by stage approach was adopted to solve some of the problems of diagnosing and managing acute abdominal pain. Audit started in hopsital and was extended, with the help of a community physician, to cover the practice of a group of general practitioners. Referrals to the accident and emergency department for acute abdominal pain were analysed, and the diagnostic accurancy of general practitioners, accident department staff, and ward staff was assessed. The accuracy of hopsital staff was improved by issuing guidelines and checklists to help in diagnosis. The general practitioners' problems were defined and discussed with the surgeons. The audit continues with the aim of improving the general practitioners' diagnostic accuracy.