[Perceptions of quality in health sectors and impact on quality assurance]

According to the ordinances dated April, 24.1996, clinics and hospitals should launch an internal accreditation process. There are many organizations which are about to develop a quality improvement process in order to be prepared to such an evaluation. The success of such approach lies on the involvement of the members of the organization concerned. This survey intends to sort out the actors' perceptions of quality, in order to adapt the process development to the internal cultural context. The data collection was realized through thirty pre-oriented interviews with physicians, nurses, administrative managers and private consultants in charge of implementing the quality process in health structures. The recorded interviews were later on analyzed in order to determine meaningful categories of perceptions of quality. The analysis reveals that quality is perceived in different ways. Three categories of perception can be found: Quality related to "a mean to change the organization" Quality as a "tool to control and limit the expenses" Quality as a way "to improve the relationship with the patients". Administrative managers rather consider the quality process as an expense control tool, whereas physicians and consultants perceive it as a mean to change the organization. Nurses rather adopt the quality process as a way to improve the relationship with the patient. The understanding of how the quality concept is perceived by the different personnel categories helps to initiate appropriately the improvement quality process in services.