title: Automated versus manual audit in the emergency department.
abstract: OBJECTIVE
  The purpose of this paper is to compare data collected by automated form processing with manual data collection for clinical indicators (CIs) in paediatric emergency medicine.
  
  
  METHODS
  Paediatric patients presenting with croup, asthma, bronchiolitis, head injury and gastroenteritis in August 2006 were identified by ICD 9 coding and a traditional manual audit was performed by two data collectors. Data were collected on a total of 16 CIs for these five illnesses. Manual audit data were then compared to information collected for this same patient population using TELEform, an automated forms processing (AFP) system that had been employed for over two years.
  
  
  RESULTS
  Teleform data were only available for 24 patients compared to information for 127 patients identified by ICD 9 coding and manual audit. Teleform data overestimated compliance with clinical guidelines by 17 percent giving an overall departmental agreement with CIs of 90.6 percent compared to 73.5 percent in the manual audit. Additionally, manual audit demonstrated that when the clinical guideline was incorporated into the clinical record, compliance was 92.5 percent compared to 51.3 percent when it was not.
  
  
  CONCLUSIONS
  This single center study demonstrates that data collected by AFP such as TELEform, overestimate emergency department performance regarding CIs compliance. Departments that use automated data collection tools need to establish relationships between such data and data collected via more traditional auditing methods.
authors.affiliation: Rural Clinical School, University of Newcastle, Tamworth, Australia. Steven.Doherty@hnehealth.nsw.gov.au
authors.forename: Steven
authors.initials: S
authors.lastname: Doherty
authors.forename: Lin
authors.initials: L
authors.lastname: Davis
authors.forename: Paul
authors.initials: P
authors.lastname: Leschke
authors.forename: Anna
authors.initials: A
authors.lastname: Valpiani
authors.forename: Emma
authors.initials: E
authors.lastname: Whitely
authors.forename: Della
authors.initials: D
authors.lastname: Yarnold
authors.forename: Helen
authors.initials: H
authors.lastname: Stevens
mesh_terms: D000293:Adolescent; D001315:Australia; D001988:Bronchiolitis / Q000175:diagnosis / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000175:diagnosis / Q000628:therapy; D019091:Critical Pathways; D003440:Croup / Q000175:diagnosis / Q000628:therapy; D004636:Emergency Service, Hospital; D005759:Gastroenteritis / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008485:Medical Audit / Q000379:methods*; D008492:Medical Informatics Computing; D017410:Practice Guidelines as Topic