title: Interface flow process audit: using the patient's career as a tracer of quality of care and of system organisation.
abstract: OBJECTIVE
  This case study aims to demonstrate the method's feasibility and capacity to improve quality of care. Several drawbacks attached to tracer condition and selected procedure audits oblige clinicians to rely on external evaluators. Interface flow process audit is an alternative method, which also favours integration of health care across institutions divide.
  
  
  METHODS
  An action research study was carried out to test the feasibility of interface flow process audit and its impact on quality improvement. An anonymous questionnaire was carried out to assess the participants' perception of the process.
  
  
  RESULTS
  In this study, interface flow process audit brought together general practitioners and hospital doctors to analyse the co-ordination of their activities across the primary-secondary interface. Human factors and organisational characteristics had a clear influence on implementation of the solutions. In general, the participants confirmed that the interface flow process audit helped them to analyse the quality of case management both at primary and secondary care level.
  
  
  CONCLUSIONS
  The interface flow process audit appears a useful method for regular in-service self-evaluation. Its practice enabled to address a wide scope of clinical, managerial and economical problems. Bridging the primary-secondary care gap, interface flow process audit's focus on the patient's career combined with the broad scope of problems that can be analysed are particularly powerful features. The methodology would benefit from an evaluation of its practice on larger scale.
authors.affiliation: Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium. jpunger@itg.be
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Unger
authors.forename: Bruno
authors.initials: B
authors.lastname: Marchal
authors.forename: Sylvie
authors.initials: S
authors.lastname: Dugas
authors.forename: Marie-Jeanne
authors.initials: MJ
authors.lastname: Wuidar
authors.forename: Daniel
authors.initials: D
authors.lastname: Burdet
authors.forename: Pierre
authors.initials: P
authors.lastname: Leemans
authors.forename: Jacques
authors.initials: J
authors.lastname: Unger