[On healthcare quality]

The quality of health care can be defined and measured. The "health basket" and private practice are parameters on the quality of care, whilst each has its problems and is under attack. Additional factors influencing the quality of care are: under-use, over-use and ill-use. Errors, both organizational and individual, adversely affect the quality of care. Errors can be prevented by correct planning of care systems, including diagnostic and treatment protocols and multidisciplinary methodologies incorporating joint control and evaluation. The reporting of both errors and normal results, within institutions as well as publicly, are vastly important in fostering a culture of quality. In contrast with industry, in which the six sigma/3.4 failures per million opportunities has been widely and successfully implemented--there is no systematic approach to error reduction in health care. An effort to improve quality begins with education and continues through the use in health care of methodologies utilizing protocols supported by evidence-based medical practice. The illustrious clinician of old differs from today's sought after practitioner. The correct blend of these ingredients can induce a breakthrough into a higher quality of care.