Evolving principles of office quality assurance.

The application of medical quality assurance principles to ambulatory patient care using the traditional methods of medical chart audit, process review, and physician education has yielded generally disappointing results in improving patient care and physician performance. Newer methods assist physicians by providing patient and medical reference data at the time of a patient's visit. Techniques for tracking treatment outcomes and patients' test results and for providing instructions to patients may improve both care and patients' and physicians' satisfaction. This feature appears regularly in THE WESTERN JOURNAL OF MEDICINE. It is intended to cover recent developments in a broad range of issues that will have an impact-either directly or indirectly-on clinical practice. Occasionally the seminars may include informed speculation about likely future developments.