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November 18, 1988

Assuring Quality Out-patient Care for Children: Guidelines and a Management System

Author Affiliations

Children's Health Center Thomas Jefferson University Philadelphia

Children's Health Center Thomas Jefferson University Philadelphia

JAMA. 1988;260(19):2934. doi:10.1001/jama.1988.03410190182053

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


This book describes the development, implementation, and evaluation of a quality assurance system for pediatric ambulatory care. The system (Pediatric Protocol Project) is now used in emergency departments and walk-in clinics in several large New York City hospitals that are staffed by physicians with various levels of training and experience. The system described consists of four components: (1) standards for optimal care, (2) structured encounter forms, (3) a computerized management information system, and (4) parent education materials designed to improve compliance and decrease unnecessary utilization of emergency services.

The writing is clear and concise, and the book is well organized and liberally referenced. There is an interesting chapter about the history of quality assurance efforts, from Hippocrates and Florence Nightingale up to modern computer systems. The authors outline many of the methodologies that have been utilized in quality assurance programs and discuss some problems associated with each of them.