Health care quality assurance: tracer analysis in quality assessment of ambulatory care provided by two out patient teaching clinics.

Population-based assessment of medical care provides information on the quality of care generated by a health care facility over a range of services. Patient chart review was undertaken via "tracer analysis" at two ambulatory care teaching clinics to obtain a measure of the clinical services provided by chiropractic interns for a range of diagnoses. The assessment indicated that chiropractic interns perform best when rendering care for spinal conditions. However, a greater emphasis on development of clinical problem-solving skills versus the use of routine standardized examination procedures would improve the quality of care across a broader spectrum of conditions encountered within the patient base of the clinics. Improved documentation of concurrent medical care or medical referral is warranted in instances of systemic comorbidity.