QUALITY OF CARE ASSESSMENT AND ASSURANCE
| Method | Characteristics |
| Traditional peer review (process usually) |
Physicians review and judge charts without specific criteria, but use professional judgment (implicit criteria). |
| Medical record audit (process usually) |
Review of record using precise and explicit criteria, focusing on specific types of care or diagnoses. |
| Structure audit | Review of facility and organization against specific requirements, such as adequacy of physical facilities or staff. |
| Baseline audit (process-oriented) |
Chart review against care activities necessary to assess health status. |
| Clinical audit (process-oriented) |
Implicit peer review for specific diseases examining clinical management; developed along with baseline audit. |
| Tracer methodology | Follows tracer problems examining explicit process and outcome measures that are interrelated; population, diagnosis, treatment, and outcome measures involved. |
| Criteria mapping (process-oriented) |
Maps out the care that a good physician would provide using protocols and audits care against these care patterns. |
| Staging method (process- and outcome-oriented) |
For certain diseases, defines stages of diseases that patients can be in and measures whether patients progress to sicker stages and role of care, if any, in the progression. |
| Health accounting (outcome-oriented) |
If outcomes for groups of patients do not match expectations, further investigation is triggered; patients with a specific problem are examined before and after care is provided to measure outcome or change in status; if care is questioned, process studies are required. |
| Outcome measurement | Varies widely; often based on mortality and morbidity data. |
Ross, Austin, Williams, Stephen J., and Schafer, Eldon L., Ambulatory Care Management, p.210.