QRB. Quality review bulletin
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In 1990, Schumpert Medical Center, Shreveport, Louisiana--a 625-bed acute care hospital--established an acute pain service (APS) department and implemented the ten-step monitoring and evaluation process as recommended by the Joint Commission to facilitate the quality assurance program for pain management therapy. The program, which entails the cooperative effort of anesthesiologists and registered nurses, is intended to provide individualized pain management therapy to qualified APS patients on a 24-hour, seven-day-a-week basis. Through continuous, systematic monitoring and evaluation of six aspects of care and their indicators and thresholds, the quality of APS patient care can be determined and improved.
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The third of a series on the Institute of Medicine study on a quality review and assurance program for Medicare, this article describes findings on two separate series of focus groups held with Medicare beneficiaries and with physicians in private practice. The respondents' perceptions of quality of care, understanding of the Medicare program and QA activities, and recommendations for improvement are reported directly and examined for implications for designing a coherent QA strategy. A surprising finding is that both beneficiaries and physicians define quality of care in terms of the "art of care" as well as in technical and clinical terms.
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The Departments of Respiratory Care and Medical Informatics at LDS Hospital, Salt Lake City, developed a computer-assisted system (HELP) to monitor the quality assurance (QA) of respiratory care services. The system addresses the immediate needs of patients through a daily medical director's alert report, which allows the medical director to intervene in acute situations as they arise. The department's QA program monitors and evaluates clinical indicators of staff performance in terms of stated policies and procedures. The integrated data base allows functions to be performed without labor-intensive chart reviews.