has led to the introduction of a wide range of quality and audit initiatives which seek to define, measure, guarantee or improve standards of patient care.
When we talk about quality assessment in health care, we find a range of different terms in use, for example, quality assurance, quality control, quality improvement, audit, accreditation and so on. Although the language and terminology we use may vary between professional groups and from one country to another, when we think about evaluating the quality of health care, we are typically referring to a cyclical process with a number of key stages:-
・ Defining the level of quality we want to achieve (in the form of standards, criteria, guidelines or protocols)
・ Implementation of the agreed standards in practice
・ Measuring and comparing to see how far we have reached the defined level
・ Taking action to improve quality where necessary.
However, despite the fact that most approaches to quality evaluation share this common framework of defining, implementing, measuring and taking action, they can be seen to differ on a number of key and fundamental dimensions. For example, in terms of:
・ Who is responsible for negotiating the cycle?
・ Who defines what level of quality we are aiming for?
・ Who undertakes the measurement and evaluation?
