Abstract
The Medical Management Analysis (MMA) system of quality assurance by screening medical records for “occurrences” was trialled at the Royal North Shore Hospital, a major 780 bed teaching hospital in Sydney, in 1988. This Californian approach has now evolved into a more focused hospital-based peer review system (called QARNS) which is operating effectively and efficiently at the hospital. Whilst still based on the 23 MMA criteria, QARNS has achieved greater acceptance and action from the clinical staff. Implementation of QARNS at the other four acute general hospitals within the adjacent Area Health Service is now under active consideration.
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