Utilization review and quality assurance: staying in the black and working with the blues

Utilization review (UR), Quality Assurance (QA), and Peer Review (PR) have become essential aspects in the practice of general hospital psychiatry. This article first defines and elaborates the basic elements of UR, QA, and PR and then outlines the development of a program for these professionally initiated and maintained methods of problem seeking and solving as it occurred on a short-term voluntary inpatient psychiatric unit. Finally, current trends and conflicts inherent to QA, UR, and PR are discussed, with a view towards the future.