Quality assurance in a public health agency.

Quality assurance (QA) activities in public health programs typically are fragmented. The Division of Public Health of Maricopa County in Phoenix decided to develop a comprehensive QA program in 1981 that involved both the development of clinical protocols and the formalization of procedures for planning, executing, and following up on QA studies. A clinical protocols committee was formed to generate protocol manuals that serve as the principal criteria source for QA studies. A QA committee was also established to set guidelines for studies and to supervise their execution. Thus far, the QA program has resulted in a significant increase in QA activities within the public health division and improvements in many aspects of patient care.