・And who should plan and implement action for improvement?
Tracing the developments in quality assessment in health care and comparing different approaches, it is possible to identify discrete ways in which the cycle of quality evaluation has been approached. Influenced by similar experiences within the industrial quality movement, three distinct models of quality assessment can be identified. These can be defined as follows:-
・ Quality as the responsibility of individuals
・ Quality as an exercise in inspection
・ Quality as a means of continuous improvement (Harvey 1996)
I will briefly describe each of these three approaches in turn.
Quality as the responsibility of individuals
This represents the most traditional approach to evaluating quality. Typically, it reflects a craft-based approach to work, where individuals are responsible for all stages of their own work, from planning through to monitoring and evaluation. Statements of quality are not made explicit, but are seen as a product of an individual's professional training and role. This model of implicit quality evaluation by highly skilled and committed practitioners is one that is familiar to most professional practice and has been successful in promoting excellence in practice.
