文本框: QUALITY OF CARE ASSESSMENT WITHIN THE NETWORK 《RESEAU MERE-ENFANT》 Bernard-Bonnin A-C, Campillo S, Amyot I, Belhumeur C, Gaudreault P, Lebel MH, Desmarais D, Hamaoui C, Hamel P, Lanctot G, Rock N, Roy V. Dept.of Pediatrics, Reseau Mere-Enfant, University of Montreal, Montreal, Canada Objective: Quality of care assessment has become mandatory in hospital practice. This study evaluated the quality of care delivered to children hospitalized for gastroenteritis within the pediatric departments of seven hospitals of the 《Reseau Mere-Enfant》(RME) . Methods: Eleven criteria were listed after consensus among members of the Quality of Care Committee (QCC) of (RME). The proportion of charts meeting the criteria was estimated in each center. All cases that did not meet the criteria were reviewed at the QCC until a consensus was reached. Results: 350 charts, distributed evenly among the 7 pediatric departments, were studied. Quality of care was estimated as very good, since 8 out of 11 criteria were met in more than 87% of cases (87-99.7%). Documentation of blood in stools, foreign travel, and prior antibiotic use was recorded in 26% of charts and varied between 8 and 44% across centers. Stool cultures were performed without justification in 22% of cases (10-34%), and urine cultures in 34% (8- 62%). Use of parasitologic studies, Clostridium difficile toxin, and rotazyme was adequate in 94% of cases. Antiemetic and antikinetic agents were used in 3% of cases. Antibiotic prescriptions were not clinically justified in 0.3% of cases. Reintroduction of milk and solid foods occurred within 36 hours of admission in 98% of cases. Conclusion: Quality of care for gastroenteritis is very good throughout RME. History of blood in stools, foreign travel, and prior antibiotic use should be systematically recorded in the chart. Stool and urine cultures should be restricted to specific circumstances. Rotazyme is a useful adjunct to the management plan. This innovative initiative shows the feasibility of quality of care assessment within a network of several pediatric departments. 0690