quality evaluation, as, for example, was observed within the industrial quality movement.
The traditional organisation of nursing care tended to be along the lines of task allocation, with individual nurses responsible for specific tasks within the care process. Perhaps not surprisingly, therefore, when explicit quality evaluation began to emerge as a concern, particularly from the 1970's onwards, the predominant model adopted was one of inspection. This is apparent in the widescale adoption of pre- formulated or 'off-the-shelf' quality monitoring instruments, which share common characteristics of defining and monitoring quality externally to practice, for example, the Phaneuf Nursing Audit (Phaneuf, 1976), the Slater Nursing Competency Rating Scale (Wandelt and Stewart, 1975), the Quality Patient Care Scale (Wandelt and Ager, 1974), the Rush-Medicus Index (Jelinek et al, 1974) and its anglicised version, Monitor (Goldstone et al, 1983).
However, with increasing use of external quality assessment techniques, both in the UK and overseas, a number of concerns began to be raised, both in relation to the validity and reliability of the instruments themselves (Goodwin and Prescott, 1981; Redfern and Norman, 1990; Tomalin et al, 1992; Tomalin et al, 1993), and also their ability to change practice and improve patient care (Smeltzer at al, 1983; Giovannetti et al, 1992). Prompted by these concerns, new methods of quality evaluation began to emerge, clearly reflecting a move towards a philosophy of quality as improvement and opportunity. This shift in philosophy and approach was characterised by the development of the so-called practitioner-based methods, for example, the unit-based approach (Schroeder and Maibusch, 1984; Giebing, 1987) and the Dynamic Standard
