SELF AUDIT - a basic introduction. J. Wilson(2000).

Self Audit
What does this mean to you and the way you work? Is it an examination of yourself and how you work? Perhaps I may share my thoughts on the matter with you?

Introduction
In Trichology, and in many other professions, we may often work alone.

Recently there has been much publicised media coverage of cases where standards fell grossly short of the ideal. A recent case revealed that a doctor, working on his own, allowed his 'standards' to murder his unfortunate patients. An extreme case of course, but the principle is the same. The doctor clearly did not carry out an 'audit' on his working practices. Because he was in such a position of trust, neither did any one else for a long time, with disastrous results for his patients.

Another unfortunate case was in a Pharmacy when a trainee pharmacist, under the care and supervision of a qualified pharmacist, made a mistake on dilution strengths. This error very sadly resulted in the death of a young baby. (The pharmacist in question checked each bottle used, and checked the final product label).

The error occurred because the pharmacist had not checked each and every measurement involved at the assembly stage.

NOTE
Each of these cases involved members of highly respected professions, known to be meticulously careful in their work.

TRICHOLOGY
Now as a Trichologist, I would like to expand on the audit theme.

To maintain standards we need to be questioning ourselves all the time. (the following list is not exhaustive by any means):

This is surely how a true professional should be thinking and acting?

All right, no one is, or ever will be perfect, because beings are individuals. However, this should not deter us from striving to reach high personal goals.

Recent communications suggest that Parliamentary intervention of the work of practising trichologists, and conditions of practice, is very much on the cards.

Are we ready?
One particular area where possibly many of us could improve is in the dispensary. (Sorry, as a pharmacist I was bound to throw this one in).

Legally you can only prescribe for and supply to a patient/client you have seen, and for whom you are personally prescribing.

This eliminates the stockpiling of numerous ready prepared products. However in reality we know that a certain range of stock products will be kept and issued when required.

Now we can question ourselves?
How careful are we in keeping records of theses "stock products" and their manufacturer? If we buy 'ready made', do we keep an efficient logging system of date of purchase, supplier, quantity, expiry date etc?

If we assemble ourselves, do we have an impeccable logbook which details each ingredient, and quantities of ingredients used in a particular product? (To indicate a decimal point incorrectly is a very common error).

Do we list the manufacturer's product licence number, date of expiry, package size, and also a date of our assembly, quantity etc? Do we give each of our own batches a reference code which we can refer back to?

Performance
So we are being very careful, we are double checking dilutions or additions, either with ourselves, or ideally with another person. We have decided to keep a date-related logbook of supplies/ingredients received in, and products assembled together, with each ingredient and its details: Now we are in position to follow an audit trail.

Problems
Just suppose something goes wrong. Trichologists work mainly on the head, BUT, products could come into contact with the eyes or ears, and injury to these areas may appear to be related to your product.

The patient having treatment for a scalp problem, may coincidentally develop alopecia areata syndrome.

Now, with your perfectly logged record book, if the need arises you can trace back to the ingredients, assembly of product, and date of assembly and sale of product. (Audit trail). Such information could be of great value in Court!

Legal position
No law (yet!) states that you have to achieve such a high level of perfection in your professional work, but it would go a long way towards establishing that you operate good working practice procedures should such problems arise. Remember, the people you have as patients are 'ordinary folk' who can when 'damaged', become litigious.

Perspective
With professional audit put into practice, you not only raise your own standards of practice, but also give an impeccable service to each client.

Don't be put-off by what may seem to be additional complications on the day's work. Remember that you are the professional doing and giving of your best continually. Anything you personally do to raise your own standards will also help those working with you. Our duty is to give every patient the very best of our expertise.

Finale?
There can never be a finale to self audit; by definition it is a never ending process, the ultimate object of which is presumably to provide a better caring service for our patients. As part of this caring any doubts or 'niggles' should be enquired into and acted upon if required. Don't be afraid to involve others. Share thoughts. The viewpoint of the other 'man' can often be of value when dealing with a problem. Don't be afraid to take advice, and of course, give advice if asked. Never isolate yourself; to do so is a certain recipe for stagnation. The medical and pharmaceutical world is continuously changing, and trichology is part of this process. An on-going process of self audit will ensure that you keep up with these changes.

Jean Lockhart Wilson MPS LTTS (2000)