The differences in social service were not significant . .."An exhaustive discussion of all the aspects of hospital care that could be included in such a profile will not be attempted.Instead it is proposed to deal with some of the methodological problems involved.The main techniques used in appraisals of hospital quality can be divided into: * The examination of prerequisites or desiderata"for adequate care.* Indexes of elements of performance.* Indexes of the effects of care.* Qualitative clinical evaluations.By Set Standards of CareAccording to the first approach, it is assumed that it is possible to select prerequisites for ade- quate care and that improvement of these fac- tors leads to improved care.These prerequisites are minimum or optimum levels of facili- ties, equipment, professional training, and or- ganization.As examples we may mention: * The provision and appropriate maintenance of adequate physical facilities.* The existence of special facilities, such as blood bank, bone bank, special laboratory and diagnostic facilities, premature nursery, and artificial kidney.* An effective organizational structure, both administrative and professional.* Standards and functioning of service depart- ments such as records, laboratories, and libraries.* Numbers of personnel by size of hospitalinterns, residents, nurses, social workers, phys- ical therapists, nutritionists, technicians.* The availability of specialized personnel for consultation and of facilities for consultation with others, as in certain regional programs.* Arrangements for ward rounds, refresher courses, continuing education.
Mindel C. Sheps (Sat,) studied this question.