Commentary on a national invitational seminar on quality assurance in health services

This paper is a slightly modified version of a paper presented at a quality assurance seminar at Royal North Shore Hospital, Sydney on 7 December 1990. The paper uses the seminar given by Professor Avedis Donabedian in Sydney 13-17 August 1990, to emphasize two issues. First, while there are claims from many hospitals that they are conducting quality assurance, such activity demands the use of explicit criteria in one form or another and, in the author's view, few if any hospitals are, in fact, using this technology. What, then, of their claims to be conducting quality assurance? The second point is that Australian efforts at quality assurance have been focused on projects, ignoring the need for a program or system in the hospital, and a program or system is essential if efforts at ensuring effective quality assurance are to succeed.