EFFECTIVENESS OF THE DAILY RECORD REVIEW AT THE MEDICAL EMERGENCY ROOM DEPARTMENT IN A FRENCH TEACHING CHILDREN'S HOSPITAL

We evaluate the effectiveness of the daily record review (DRR) of 4393 ambulatory medical patients seen at the emergency room department of a teaching pediatric hospital in Paris between 8th January and 11 March 1991. For these patients, 137 potential quality problems were found, 117 of them remaining after discussion with the junior. For 80 of the 117 confirmed problems (68.4%), the reviewing senior estimated that sufficient advice had been given to the child's usual caretaker or health care provider and (or) the children returned to seek medical advice when indicated. Experts proved the procedure to be reliable: they detected aproblemfor36% of the cases with potential quality problems and for only 2% of a sample of control records considered without potential quality problems after the DRR.