Abstract
In 1989 a UK government White Paper introduced medical audit as a comprehensive and statutory system of assessment and improvement in quality of care in hospitals. A considerable body of research has described the evolution of medical audit in terms of a struggle between doctors and National Health Service managers over control of quality assurance. In this paper we examine the emergence of medical audit from 1910 to the early 1950s, with a particular focus on the pioneering work of the American surgeons Codman, MacEachern and Ponton. It is contended that medical professionals initially created medical audit in order to articulate a suitable methodology for assessing individual and organisational performance. Rather than a means of protecting the medical profession from public scrutiny, medical auditing was conceived and operationalised as a managerial tool for fostering the active engagement of senior hospital managers and discharging public accountability. These early debates reveal how accounting was implicated in the development of a system for monitoring and improving the work of medical professionals, advancing the quality of hospital care, and was advocated in ways, which included rather than excluded managers.
Original language | English |
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Pages (from-to) | 23-47 |
Number of pages | 25 |
Journal | Accounting History Review |
Volume | 23 |
Issue number | 1 |
Early online date | 14 Mar 2013 |
DOIs | |
Publication status | Published - Mar 2013 |
Bibliographical note
The authors wish to thank the two anonymous reviewers for their insightful and helpful comments.Keywords
- end results
- medical audit
- professional accounting
- quality of care