This study proposes five alternatives for improving the safety of commercial centers, as follows: (a) implementing audit and evaluation system, (b) establishing reliability management system for fire fighting equipment, (c) monitoring and analyzing accidents and preparing GIS maps, (d) implementing 5S system in workplace and (e) establishing a reliability management system for safety trainings.
These indicate the difficulty one may have in implementing audit and applying the Plan-Do-Study-Act cycle as a reinforcement strategy.
It would require transparency when it comes to how and why claims for mental illness are denied and implement audits to ensure the rules are being followed.
However, just over 80% of Trusts implemented audits of compliance to antibiotic guidelines (dose, route and duration).
However, we have continued working on the quality of obstetric care in this setting and believe that the results are still relevant for current efforts to implement audits.
From an implementation science perspective, the next research question becomes how to implement audit and feedback routinely as part of ongoing routine health-care improvement.
Three respondents attributed the death of previous audit committees to the failure of the hospital administration to implement audit recommendations.
Its success, however, depends on the commitment of all stakeholders including care providers and relevant decision makers to implement audit recommendations.
Viewing the implementation and maintenance of an audit programme as a process, as described in this paper, could be helpful in ensuring the success of future efforts to implement audit programmes like PPIP.
Nationwide perinatal mortality audits in the Netherlands are the result of a joint effort by government and professional colleges to implement audit in all of the country's 90 obstetric units [ 30, 31].
Failure of the hospital decision makers to implement audit recommendations is worrisome and could be associated with demoralization of staff and failure to improve the quality of care as reported in other places [ 17, 24, 25].
