A continuous quality improvement program can provide the means through which medical organiza tions can guide their activities. This article illustrates how a pediatrics department in an urban medical center incorporated continuous quality improvement into the management of health services. Key elements of the Quality Assurance program included the orga nization and facilities in the department of pediatrics, important processes related to patient care, and out come measures. If a structure is established that al lows participation in decision-making and mutual ad justment, trained professionals can perform up to their standards and those standards of their peers. Involvement of physicians in the design of quality management programs and other administrative strategies offer an opportunity to develop a working formula for ongoing success.
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References
1.
Angaran D.Selecting, developing, and evaluating indicators. Am J Hosp Pharm1991;48:1931-1937.
2.
Berwick DMContinuous improvement as an ideal in health care. N Engl J Med1989;320:53-56.
3.
Berwick DMMeasuring health care quality. Pediatr Rev1988;10:11-16.
4.
Berwick DMPeer review and quality management: are they compatible? QRB1990;16:246-251.
5.
Brotherton B. , Babka JCQuality utilization management department key to solving QA problems. Joint Commission Perspect1991;3:12-13.
6.
Chirico-Post JA, Creech DF, Stoelting HIGeneric screening as an integral part of quality management. Qual Assurance Utilization Rev Physicians1990;5:36-41.
7.
Crede WB, Hierholzer WJUtilization review and management: a brief analysis of a growth industry. Infect Control Hosp Epidemiol1989;10:33-36.
8.
Health One, Deloitte and Touche.Managing care and costs: strategic choices and issues. 1991 .
9.
Demlo LKAssuring quality of health care: an overview. Evaluation and the Health Professions1983;6:161-197.
10.
Donabedian A.Criteria and standards for quality assessment and monitoring. QRB1986;12:99-108.
11.
Donabedian A. TheDefinition of Quality and Approaches to its Assessment. Ann Arbor, MI, Health Administration Press Perspectives , 1986.
12.
Eisenberg JMDoctors' Decisions and the Cost of Medical Care. Ann Arbor, MI, Health Administration Press Perspectives, 1986.
13.
Feldstein PJHealth Care Economics. New York, John Wiley and Sons, 1988.
14.
Harchelrod FR, Martin ML, Kremen RM, et al. Emergency department daily record review: a quality assurance system in a teaching hospital. QRB1988;14:45-49.
Ottensmeyer DJ, Key MKAssuring quality in proprietary managed care systems. Qual Assur Utilization Rev Physicians1988;3:75-78.
22.
Patrick MSBenchmarking-targeting "best practices." Healthcare Forum Journal1992;35:7-8.
23.
Rohrer JEThe secret of medical management. Health Care Manage Rev1989;14:7-13.
24.
Rogers WH, Draper D., Kahn KL, et al. Quality of care before and after implementation of the DRG-based prospective payment system. JAMA1990;264:1989-1994.
25.
Sanazaro PJ , Mills DHA critique of the use of generic screening in quality assessment. JAMA1991;265:1977-1981.
26.
Schyve P., Prevost A.From quality assurance to quality improvement. Psychiatr Clin North Am1990;13:61-71.
27.
Vladeck B.Quality assurance through external controls. Inquiry1985;25:100-107.
28.
Walton M.The Deming Management Method. New York, Putnam Publishing Group, 1986.
29.
Wiatrowski MD , Palkon DSPerformance appraisals in health care administration . Health Care Manage Rev1987;12:71-80.
30.
Wyszewianski L.The emphasis on measurement in quality assurance: reasons and implication. Inquiry1988;25:424-433.
31.
Zusman J.A letter and reply: peer review and quality management: are they compatible ? QRB1990;16:418-420.
