Monitoring and evaluation in an Army health clinic

In 1987, the authors implemented an indicator monitoring system that allows for ongoing evaluation of important aspects of care at the Erlangen Health Clinic, Erlangen, Federal Republic of Germany, a U.S. Army primary medical clinic serving approximately 1,200 patients a month. Staff developed prospective and retrospective indicators based on identified high-risk, high-volume areas, and established thresholds of evaluation for each of the indicators. A numerical auditing mechanism is used to record compliance with established objective criteria that determine whether or not a case is deficient. A peer review committee reviews and recommends actions for deficient cases.