Quality assurance: The experience of a geriatric psychiatry day hospital

Since December 1994 the staff of the Geriatric Psychiatry Day Hospital (DH) of Lausanne has collaborated in the program Quality Assurance in Mental He alth Care of World Health Organization (WHO). A check-list and glossaries o f indicators were prepared to assess the quality of such facility. These in dicators are classified in 8 domains. A first assessment of the quality of care at the DH made in January 1995 estimated that the global result was fa ir. An important effort was made to improve the quality of the admission, t he discharge and the care process. A model of care for each one of these pr ocesses was made. If these models are unable to describe all clinical situa tions at the DH, there is an attempt to assess the complex and long care pr ocess as well; they are useful to prepare as strategy to improve the qualit y of care. After this first step, quality of care indicators were chosen an d a strategy for their assessment was created. This article describes: (I) the quality assurance program made at the Geriatric Psychiatric Day Hospita l of Lausanne; (ii) the strategy for the assessment of the quality indicato rs; (iii) the computerized system developed to support the program; (iv) th e results of the intervention to improve the quality, particularly of the a dmission process.