3 Retrieval of data.
4 Identification and analysis of variations.
5 Recommendation of corrective action.
(2) Utilization review. Utilization review examines the efficient use of
professional medical care, services, procedures, and facilities. It's focus is on three
The necessity of medical intervention.
The level of medical intervention.
The efficiency of the health care team.
Typical areas of interest in a utilization review are: length of stay (LOS) by the patient; use
of resources; and costs to the institution and to the consumer.
e. Summary. The ultimate goal in evaluating quality of care is to decrease
disease, death, disability, discomfort, and disaffection. All of the approaches to evaluation
described are appropriate methods.
Section III. AMEDD QUALITY ASSURANCE PROGRAM
SCOPE AND COMPONENTS
a. Scope. The Army Medical Department's (AMEDD) Quality Assurance Program
(QAP) encompasses all services provided by a hospital from food service to surgery--
radiology to housekeeping. The focus of the QAP is on identifying and assessing
problems directly and indirectly related to the delivery of health care, and initiation of action
to improve the quality of care.
b. Components. Policies, procedures, and responsibilities for the administration of
the QAP are established by AR 40-68. Components are:
(1) Patient care evaluation (assessment). Patient care evaluation is a
process which assesses the quality and/or nature of utilization of an aspect of health or
dental care services. It can be performed either concurrently or retrospectively and is
accomplished by observation of medical record audit.
(2) Credentials review and privileging. Credentials review includes
verification of current licensure, certification, or registration (as appropriate). The
privileging process is directed solely and specifically to the provision of quality patient