Quality News

institutions, and revised hospital accreditation guidelines have sharpened the clinical and administrative hospital staffs‘ concern for evaluating the quality of care they provide. Evaluation is particularly important for detecting and rectifying, as early as possible, any adverse effects caused by recent cost-containment efforts. Physicians have traditionally enjoyed a great deal of autonomy in their practices, and the mechanisms for monitoring and assuring the quality of the care they provide in hospital have tended to be based on internal peer review.23 Time, however, has torn away much of the curtain of professional mystique. The growth of the consumer movement, governmental concerns about spi-ralling health care costs, public policy debates over health care priorities, financial restraints on health care



Physicians and administrators now must face the challenge of establishing comprehensive and vigorous systems of quality assurance and learn to avoid the traps that impede implementation of such systems. Much of the insecurity and frustration that they feel can be avoided by remembering that quality assurance is a very simple process that deals with finding problems and fixing them.



Implementation of a quality assurance program does not imply that some unknown authority is about to challenge physicians or administrators on how they practice their professions, and the program should not be regarded as yet another bureaucratic measure that diverts time and energy from the important business of caring for patients; quality assurance is simply the systematization, documentation and assessment of certain evaluative activities and should be seen as a
stimulus that makes these activities as rigorous and pertinent as possible. Indeed, it may be argued that a hospital’s attention to quality assurance is one indicator of the overall quality of care provided by the hospital.

making it work
Thus, a comprehensive definition of quality health care would be as follows:
The optimal achievable result for each patient, the avoidance of physician-induced (iatrogenic) complications, and attention to patient and family needs in a manner that is both cost effective and reasonably documented.
The success of any quality assurance program depends almost entirely on the commitment and interest of the administrators, nurses, paramedical staff and physicians. A lack of commitment is far more injurious to the program than any technical flaws in the evaluative process. Coordinators of quality assurance programs must select a strategy that inspires interest and commitment without burdening clinical and administrative staff with an activity they neither understand nor believe in.

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