title: Trams, trains, planes and automobiles: logistics of conducting a statewide audit of medical records.
abstract: OBJECTIVE
  This paper reports on the logistics of conducting a validation study of a routinely collected dataset against medical records at hospitals to inform planning of similar studies.
  
  
  METHODS
  A stratified random sample of 15 hospitals and two homebirth practitioners was included. Site visits were arranged following consent. In addition to the validation of perinatal data, information was collected regarding logistics.
  
  
  RESULTS
  Records at 14 metropolitan and rural hospitals up to 500 km from the research centre, and two homebirth practitioners, were audited. Obtaining consent to participate took between 5 days and 10 months. Auditors visited sites on 101 days, auditing 737 medical record pairs at 16 sites. Median audit time per record was 51.3 minutes; electronic records each took 36 minutes longer than paper. Travel time accounted for nearly one-quarter of audit time.
  
  
  CONCLUSIONS
  Delays obtaining consents, long travel times and electronic records prolonged audit duration and expense. Employment of experts maximised use of available audit time. Conducting a validation study is a time-consuming and expensive exercise; however, confidence in the accuracy of public health data is vital.
  
  
  CONCLUSIONS
  Validation studies are unquestionably important. Three alternative strategies have been proposed to make future studies viable.
authors.affiliation: Judith Lumley Centre, La Trobe University, Victoria. m.flood@latrobe.edu.au.
authors.forename: Margaret
authors.initials: M
authors.lastname: Flood
authors.affiliation: School of Nursing and Midwifery, La Trobe University, Victoria.|Department of Nursing, The University of Melbourne, Victoria.
authors.forename: Wendy
authors.initials: W
authors.lastname: Pollock
authors.affiliation: School of Nursing and Midwifery, La Trobe University, Victoria.
authors.forename: Susan
authors.initials: S
authors.lastname: McDonald
authors.affiliation: Judith Lumley Centre, La Trobe University, Victoria.|Department of Obstetrics and Gynaecology, Monash University, Victoria.
authors.forename: Mary-Ann
authors.initials: MA
authors.lastname: Davey
mesh_terms: D000401:Aircraft; D001336:Automobiles; D006801:Humans; D008485:Medical Audit / Q000379:methods* / Q000706:statistics & numerical data; D008499:Medical Records / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011890:Railroads; D015203:Reproducibility of Results; D012423:Rural Health / Q000706:statistics & numerical data; D013995:Time; D014195:Travel / Q000706:statistics & numerical data*; D014504:Urban Health / Q000706:statistics & numerical data; D014739:Victoria
keywords: audit; monitoring; perinatal data; validation