Managing quality assurance activities in a large teaching hospital

The largest teaching facility in the Southeast, Jackson Memorial Hospital (JMH) is a 1,250-bed tertiary public hospital in Miami, Florida. With eleven specialty services, 21 medical and 8 nursing departments, the task of coordinating quality assurance (QA) activities and the data generated from these activities is a monumental one. However, in one-and-one-half years, the QA program at JMH has grown from a decentralized, retrospective, audit-oriented activity to a carefully organized, comprehensive program that encompasses the problem-solving activities of all health care disciplines and tracks and concurrently monitors data generated throughout the facility. The structure of the QA program is based on a management by objectives philosophy, and the information tracking system is predicated on the support and cooperation of all administrative, medical, and nursing departments, as well as ancillary support services. In this article, the first in a two-part series, the authors describe the organization of the QA program at JMH. The second article, which will be published in an upcoming issue of the Quality Review Bulletin (QRB), will describe how a QA program can function as an effective management tool when information is tracked and monitored by a central oversight group.