Mise en place d'une démarche d'audit qualité des services d'accueil des urgences à l'Assistance publique-Hôpitaux de Paris

Quality assurance in emergency services is now a priority for health care organizations. Assistance publique-Hôpitaux de Paris (AP-HP), the regional public hospital system for the Paris metropolitan area, performed a quality audit of its 16 emergency departments in 1996. A set of criteria and standards related to the organization and quality assurance of emergency departments was established by an expert panel and then tested in six hospitals in the AP-HP. The final version was considered as a basis for auditing the emergency department organization and quality assurance programmes. The audit was performed by a team of three trained surveyors (one physician, one hospital director and one quality manager) in each of the 16 emergency departments of AP-HP during one day. The audit was based on interviews, patient circuit analysis, documentation and procedures assessment. The results identified major differences between hospitals. The results were given to each hospital with a summary of its strengths and weaknesses. Each hospital could compare its results with those of the 15 others and develop its own quality improvement plan.