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August 8, 1977

Medical Audit JCAH-Style: A Positive View

Author Affiliations

Clinton, Wash

JAMA. 1977;238(6):480-481. doi:10.1001/jama.1977.03280060023008

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To the Editor.—  Having been a Field Representative of the JCAH for the past three years, it may be considered that I have a somewhat biased point of view. However, I believe any bias would be balanced by 21 years of private practice and an appreciation of the problems of the medical staff in fulfilling their responsibility for patient care evaluation.Dr Rosenberg would favor a process audit rather than an outcome audit for patient care evaluation. It would be difficult, if not impossible, for physicians to agree on the step-by-step process that would define good medical care. There would be much resistance and resentment to the cookbook medicine approach. Process audit may put an imposing load on data retrieval personnel.Outcome audit is based on the assumption that if optimal care is rendered, there should be outcome that is commensurate with that care. The methodology, therefore, evaluates the quality