5. PERFORMING A MANUAL CHART AUDIT

f.  Local Option Question

Auditing facilities have the ability to formulate their own supplemental audit question, if desired. This permits each participating site to analyze an additional aspect of diabetes care that may be of special interest, or to "test run" a question that might be a useful future addition to the national diabetes audit. The procedure for developing and incorporating a local option question is explained below.

The first step is to develop a question that can be answered through a review of individual medical charts. The question can relate to demographics (Indian blood quantum, location of residence, etc), a particular aspect of care (examinations, lab studies, other medications, and so forth), co-morbid condition (history of stroke or MI, for example), a clinic related parameter (such as the number of visits in the preceding month or year), or other auditable element of interest.

The local option question needs to be posed in multiple choice format. The choices may be as simple as 'Yes' or 'No', or may have many possible answers. There can be up to 10 choices, although for ease of answering and reporting it is usually best to limit choices to no more than 4 or 5. Each choice needs to have an assigned number, just like other parts of the audit.

After the question and response choices are formulated, print or type them onto the lower righthand side of the audit form. If there is insufficient room, a separate sheet can be stapled to the audit form. Be sure to precede each choice with its associated single digit number.

Data entry for a local option question is easy. A special "Local Option" field is provided at the very end of the audit, and is clearly identified on the data entry screen. Responses from the audit form can be entered there in the same manner as all other data is entered.