The implementation of quality assurance monitoring is an important response to public demands for accountability in medicine as well as a requirement for institutional accreditation by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The author examines the somewhat elusive definition of quality as it is applied to medical care. He reviews the history, terminology, and reasons for quality assurance monitoring and presents the JCAHO-defined concepts of indicators and thresholds. Several common problems associated with the implementation of quality assurance monitoring are discussed along with guidelines for the development of quality assurance indicators in psychiatry.
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