BOOK REVIEW

Quality assurance and cost containment have become preoccupations for many physicians, educators, and administrators. Now, a short and pleasantly written book describes a quality assurance system for pediatric ambulatory care. It is based on the Pediatric Protocol Project developed by the authors and implemented in six large New York City hospitals beginning in 1981. Designed to address the uneven quality and unnecessary cost of the management of many common pediatric health problems, the book presents guidelines for their appropriate diagnosis and treatment; structured encounter forms designed to capture necessary data; decision trees schematically depicting the guidelines' structure; annotations explaining the logic underlying key or controversial diagnostic or therapeutic decisions; parent education materials covering the guideline problems; and a computer-driven guideline management information system.