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David B. Nash, MD, MBA

JAMA. 1995;273(19):1537-1538.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Across the land, tens of thousands of inpatient medical records of Medicare beneficiaries are being analyzed using dozens of expert-derived "indicators" about the quality of care that was delivered. This information is then transmitted to the state-based peer review organizations (PROs), who in turn evaluate and interpret the results. Finally, dozens of newly appointed physicians from the PROs, many with advanced degrees in public health and epidemiology, fan out across their respective states to share these results with hospital medical staffs. Hospitals then agree to submit quality improvement action plans for PRO approval 30 days following these cooperative feedback sessions. Gone are the days of quality by inspection as we herald a new era of nonpunitive feedback on actual performance based on national data sets and the principles of continuous quality improvement.

Does this dramatic scenario seem familiar? Regrettably, I contend that most practicing physicians are blissfully unaware of the . . . [Full Text PDF of this Article]

Author Affiliations
From the Office of the Director, Health Policy and Clinical Outcomes, Thomas Jefferson University Hospital, Philadelphia, Pa.

Footnotes
Reprint requests to the Office of the Director, Health Policy and Clinical Outcomes, Thomas Jefferson University Hospital, 1015 Walnut St, 621 Curtis, Philadelphia, PA 19107 (Dr Nash).

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