Quality assurance in health care : the official journal of the International Society for Quality Assurance in Health Care / ISQA
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As part of routine Quality Assurance (QA) activity in our Department, a quarterly audit of patient outcome after obstetric anaesthetic care is completed. Previously this consisted of a technical (criteria-based) audit and some assessment of patient satisfaction. The most recent audit was carried out by a volunteer providing a cost-effective and flexible means of data collection. ⋯ Technical details allow comparison to internal and published standards. PDO data provide a complementary means of assessing Structure, Process and Outcome. Thus, the audit permits internal and external evaluation of departmental activities and feedback of QA information necessary to a comprehensive QA program.
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This paper reports on the development and application of multiple risk-adjusted measures of hospital performance (mortality, readmission, complications). The indices are based on patient-level data so they can be aggregated at any level (hospital, specialty, physician), are easy to use and interpret by hospitals, and provide an inexpensive method for evaluating hospital performance using existing databases. This paper focuses on the development of practical applications of these measures in the quality improvement process.
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Qual Assur Health Care · Jan 1991
ReviewHigh consumers of health care in emergency units: how to improve their quality of care.
Patients with non-urgent complaints and/or who attend frequently account for a substantial portion of the visits to emergency units. These patients usually require other types of care than that provided by a highly specialized emergency department (ED). ⋯ A long-term follow-up showed that without any intervention, frequent ED users are a high-risk group as regards morbidity and mortality, especially with respect to suicide. Prevention with comprehensive and continuous treatment programmes should therefore be planned when a tendency is noted for patients to attend the ED frequently.
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The problem of malpractice suits and patient complaints is frequently mentioned in discussions concerning the quality of health care. The present paper reviews the following aspects of this problem: the magnitude of the problem, the categories of cases, insurance and legal aspects, effects on medical practice, institutionalized possibilities for solving conflicts, an answer to the question of why patients complain and sue, and risk management.