XI. Quality Assurance and Medical Education: A. Quality Assurance: The Computer as a Support Tool in a Multi-Hospital Medical Peer Review System

摘要

A computer base data system has been developed for the performance of multiple quality assurance activities in conjunction with concurrent utilization review. As patients are reviewed, an abstract is completed containing the Uniform Hospital Discharge Data Set, a record of adverse clinical events occurring during hospitalization and, as indicated, additional special study data. The computer management of the resulting patient profile sets of varying lengths and size is illustrated by the study of 7,560 surgical patients in 20 hospitals during the spring of 1980. We studied prophylactic antibiotic use, the occurrence of nosocomial infections and other complications, indications for cholecystectomy surgery, cataract removal, total hip replacement, and a restudy of the use of anticoagulants in hip surgery. Only with the computer support is it possible to conduct different studies in the same population utilizing a common core of information and the medical record already being reviewed.