EDITORIAL AUDIT AND THE OUTCOME OF OCCUPATIONAL HEALTH

measure the mortality rates and monitor the quality of patient care. She correlated morbidity and mortality rates with the intensity and quality of nursing care received by soldiers. She discovered that nursing care reduced military mortality rates by 32%. She went on to correlate hospital mortality with sanitation and unsafe environments. Since then, many researchers continued to examine the relationship between the quality of care received and individual patient outcome. Donabedian's work emphasized that three approaches are of structuring process and outcome complementary and should be used collectively to monitor the quality of care. Since that time outcome measures have had limited use. Although occupational health has embraced the concepts of clinical audit, work has tended to focus on structure and process simply for ease. With the arrival of clinical practice guidelines, time is ripe to conside