title: Impact of peer review audit on occupational health report quality.
abstract: BACKGROUND
  In a previous report, we described the implementation of a formal process for peer review of occupational health (OH) reports and a method of assessment of the outcomes of this process. The initial audit identified that 27% of OH reports required modifications.
  
  
  OBJECTIVE
  To assess formally, following implementation of this process, if changes in practice had occurred, i.e. whether fewer deficiencies were being identified in reports.
  
  
  METHODS
  We repeated a prospective internal audit of all peer reviewed OH reports between September and November 2011. We used an abbreviated assessment form, based on questions 4-8 and 10-12 of the modified SAIL (Sheffield Assessment Instrument for Letters), with four possible outcomes: no action, no changes made to report following discussion with author, changes made without discussion with author and changes made following discussion with author.
  
  
  RESULTS
  One hundred seventy-three reports by 10 clinicians were audited. The audit identified a 13% reduction in OH reports requiring modifications (from 27 to 14%) compared with the previous cycle. Where modifications were required, 8% of these were related to minor typographical, spelling and grammar errors and 6% were for more complex reasons. Implementation of this process also produced a reduction in clinical complaints about OH reports from customers, from three in the preceding year to none 2 years later.
  
  
  CONCLUSIONS
  Peer review improved the standard of OH reports and was associated with a reduction in customer complaints about reports.
authors.affiliation: NHS Lanarkshire, Salus Occupational Health, Safety & Return to Work Services, Hamilton ML3 0TA, UK, Healthy Working Lives Group, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8RZ, UK, drushca@hotmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Lalloo
authors.affiliation: Healthy Working Lives Group, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8RZ, UK, MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G2 3QB, UK.
authors.forename: E
authors.initials: E
authors.lastname: Demou
authors.affiliation: Healthy Working Lives Group, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8RZ, UK.
authors.forename: E B
authors.initials: EB
authors.lastname: Macdonald
mesh_terms: D003695:Delivery of Health Care / Q000592:standards*; D006801:Humans; D008485:Medical Audit; D008499:Medical Records / Q000592:standards*; D016272:Occupational Health; D018024:Peer Review, Health Care; D011446:Prospective Studies
keywords: Audit; occupational health; peer review; quality.