[Quality and accreditation of emergency departments]

The concept of quality has been linked to the health care world since the remote past and is one of the strategic elements on which the transformation and improvement of modern health systems is based. Study of quality in health care involves different approaches given that it holds different meanings for patients, professionals and managers. In recent years formal systems of quality management have been progressively introduced, such as certification according to the ISO-9000 Norms, the system of accreditation of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the European Model of Excellence (EFQM). Management by processes is another tool directed towards achieving the aims of total quality in the care process and tackling health problems centred on the patient. Quality health care involves evidence based clinical practice; based on current scientific knowledge, following clinical practice guidelines based on evidence, with the least risk for patients and relatives, involving greater efficiency and greater satisfaction for users and health personnel. The accreditation of health care centres and services is, without doubt, the most widely accepted method for guaranteeing quality. It can be defined as the process of external evaluation to which a health organisation is subjected, based on a review of certain accepted criteria and standards, whose fulfillment demonstrates that that centre is developing its functions within parameters of quality that at least approach excellence.