PEDIATRICS Vol. 57 No. 5 May 1976, pp. 775-782
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The Mandate Project: Institutionalizing a System of Patient Care Quality Assurance

Daniel S. Fleisher M.D.1, Clement R. Brown Jr. M.D.1, Carter Zeleznik 1, Gerald H. Escovitz M.D.1, and Charles Omdal M.D.1

1 Center of Health Education Studies and Department of Pediatrics, Temple University School of Medicine, Chestnut Hill Hospital, the Office of Medical Education, Jefferson Medical College, and the Medical College of Pennsylvania, Philadelphia

In 1970, prior to present-day requirements for quality assurance programs, a project was undertaken to institute such a program voluntarily in ten hospitals. Five hospitals succeeded in fully implementing the program which was based on the "Bi-Cycle Process" and each documented improvements in desired patient care behaviors. Two hospitals partially implemented the process and demonstrated no significant changes in desired patient care behaviors. Two hospitals failed to provide the data upon which assessments could be made and one hospital never got beyond preliminary efforts at instituting the process. The project demonstrates that a voluntary quality assurance program is feasible and has important implications for PSROs and continuing medical education. It also provides evidence that attention to psychosocial factors is essential in the institutionalization of programs designed to produce desired changes in patient care behaviors.

Submitted on May 19, 1975
Accepted on July 15, 1975




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L. K. Demlo
Assuring Quality of Health Care: An Overview
Eval Health Prof, June 1, 1983; 6(2): 161 - 196.
[Abstract] [PDF]