Quality assurance in the emergency department.

A coordinated approach to quality assurance is essential for managing the complexities of health care in the emergency department. Nearly every activity in the emergency care setting has implications that fall under the quality assurance umbrella. A comprehensive quality assurance program for the emergency department at Michael Reese Hospital was built through a process of defining, further developing, and coordinating existing quality assurance activities. Several new activities were developed to fill identified gaps. The program follows traditional quality assurance concepts for monitoring structure, process, and outcome elements of emergency care. Key principles that are the foundation of the program include active participation by all staff levels (clinical and nonclinical), standardized documentation, and specifically defined review mechanisms.