QRB. Quality review bulletin
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Now that major efforts are being made to develop clinical indicators, it is also imperative that participants in quality assurance programs have useful mechanisms to review data derived on the basis of these indicators. The decision tree is one means of conceptualizing clinical problems in a manner that can enhance both the development and review of clinical indicators. ⋯ Both individual cases and trends lend themselves to decision analysis, which can help determine the decisions likely to be appropriate. When numerical data are available, decision analysis can provide quantitative evaluations of clinical and quality assurance data.
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Emergency department staff at Valley View Medical Center, a 48-bed rural hospital in Utah, implemented a computerized log and integrated a quality assessment program within their small department. A microcomputerized relational data base format is used to keep and cross-reference patient logs and audits. ⋯ It also provides rapid, flexible reporting functions for staff and patient feedback and aids in the collection and dissemination of data to regulatory agencies. The system minimizes physician and nurse time spent in recording and collecting data, while simultaneously increasing their QA involvement.
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Structuring a workable quality assurance (QA) program for multidivision and multispecialty clinical departments presents a considerable challenge. The Medical Center of the University of California, San Francisco (UCSF) found that QA activities in such departments were best handled by a committee of department physicians assisted by a QA staff person. This article provides examples of how two departments at the UCSF medical center structured QA committees to fit their departments' individual needs and explains how these committees fit in the medical center's overall QA program.
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Burn trauma is the most devastating injury the body can sustain. Each year, 100,000 victims will sustain burn injuries serious enough to require hospitalization; 35% of these victims are children. ⋯ The primary nurse and physician collaborate with the rest of the health care team to manage all aspects of care. This approach assures that coordination of care occurs and allows the family the opportunity to maintain a unique role as the primary caregiver.