The initiation of a Quality Assurance (QA) Programme for general practitioners in Australia was initiated in 1987. It has had to meet the challenges of a diverse and independent group, but participation has been good after the first three years. The theoretical basis for the types of QA activity undertaken is discussed, as well as the political climate under which general practice QA is being established in Australia and abroad.
By focusing on its mission values, a hospital can enhance the quality of patient care, improve staff morale, promote cost effectiveness and achieve a competitive advantage in the hospital market place. Since 1986, St Vincent's Private Hospital has implemented strategies and formed task forces to clarify and apply its values to the hospital's overall direction and the everyday work setting. This work has proved that a concentration on the hospital's mission can result in quality management and can benefit both the hospital's basic 'spirit' and its bottom line. Eight guiding principles were found to be essential in achieving quality management through organizational values.
Objective: The study was undertaken to evaluate the use of the Paediatric Evaluation Protocol (PAEP) in the Princess Margaret Hospital for Children, Western Australia. A random sample of 557 patient records was reviewed using the United States Paediatric Appropriateness Evaluation Protocol (AEP).
Results: Thirteen per cent of admissions and 10% of days of stay may have been medically inappropriate in the year of study. The PAEP is a useful tool for utilization review in children's hospitals in Australia and may with benefit be modified.
Hilltop Lodge is a 16-bed unit in the grounds of Tamworth Base Hospital in Northern New South Wales, designed for the care of the confused and demented elderly (CADE). We present the results of an audit of the first 15 months of its operation performed by evaluating the course of 12 long-stay patients admitted to the unit. We found that although disruptive behavioural problems decreased and sociability improved, only minimal changes occurred in self-help skills and confusion levels. The unit also provided respite care for the temporary care of similar patients; there were major advantages and disadvantages noted, particularly in the functioning of the unit.
Objective: To seek information on the type, method and extent of quality assurance being undertaken in all public and private hospitals within Australia.
Method: Mailed questionnaire.
Results: There was a predominance of two types of review being undertaken. Some important deficiencies in the quality assurance process were identified. Far more private than public hospitals reviewed medical records and surveyed patient satisfaction.
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