Quality as an exercise in inspection
When moving to more explicit methods of quality evaluation, the quality at an individual level model often gives way to more inspection-based methods. These first developed in industry, but examples can also be recognised in health care. Inspection- based methods are characterised by a more task-based organisation of work, where individual practitioners are mainly responsible for 'doing' a task, whilst other more specialist roles take on the responsibility for planning and monitoring quality.
Quality is typically defined as the absence of errors or mistakes and external assessors or inspectors are appointed to check and remove any mistakes that might be occurring. Whilst this approach can reduce some of the problems associated with the individual approaches to quality, notably their implicit and time-consuming nature, it can also have serious implications for the morale and motivation of employees. Inspection for errors usually involves questioning the performance and productivity of practitioners and may, in the long run, result in lower performance and demoralisation at work.
Quality as a means of continuous improvement
The most recent development has been the growth of a more collaborative model of quality. Again, this emphasises the importance of explicit quality evaluation, but the approach is underpinned by principles which emphasise team-work and quality evaluation by those involved in service delivery. In many respects, the collaborative model has evolved from the limitations and negative consequences of the more inspection-based method, in particular, its more reactive, employee-focused approach to evaluation.
