Assessing the quality of care in a hospital emergency unit: a framework and its application.

This article presents a specific application of a general approach to quality assessment by describing in detail both the theoretical and the practical aspects of quality assessment in a hospital emergency unit. The theoretical framework is established by specifying the level and scope of assessment, adopting a definition of quality, modeling emergency care as a succession of phases, specifying evaluative attributes, choosing a method for case selection, and selecting one or more methods of assessment. The practical application of this framework is illustrated using two methods, "tracer" and "trajectory," and selecting specific conditions amenable to assessment with each method.