Development of Criteria for Quality Assurance of Ambulatory Child Health Care

Criteria were developed by the Joint Committee on Quality Assurance for evaluation of ambulatory child health care through chart audit. These covered history, physical examination, laboratory tests, and management in the areas of health supervision, tonsillopharyngitis, bronchial asthma, and urinary infection. Following testing for self-audit of patient records by practitioners, the criteria were rated for relevance to outcome and suitability for use in peer review by 390 "experts," half academicians and half practitioners. The experts showed marked concordance, substantially agreeing as to relevance in 203 of 211 criteria and in 199 regarding use in peer review. Only three quarters of the criteria were, however, considered relevant to outcome by 85 per cent of the experts. The study suggests that academicians and practitioners will agree well in judging criteria for peer review; however, small groups unaccustomed to the task should not be charged with developing criteria of such importance.