QRB. Quality review bulletin
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To determine the characteristics and effects of quality assurance programs in emergency medical service (EMS) systems in Michigan, medical directors of all EMS medical control authorities in Michigan were mailed a survey consisting of 14 closed-ended and open-ended questions including 2 using a subjective continuum scale; the study included phone follow-up of nonrespondents. Twenty-nine (56%) of 52 authorities surveyed responded; 28 reported that they conducted quality assurance activities. ⋯ Although 26 (92%) respondents reported that their quality assurance program made a difference in the quality of care delivered, lack of standards and resources were most frequently listed as program weaknesses. Survey findings prompted the EMS Division of the Department of Public Health, State of Michigan, to address quality assurance in statewide seminars and to develop guidelines for statewide implementation.
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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.