Current models of "quality"--an introduction for anaesthetists

The purpose of this review is to provide the practicing anaesthetist with an historical perspective of quality, a summary of current models, and an introduction to the expectations of accreditors. Articles were obtained from an electronic literature search on Silver Platter using the search terms Quality, Quality assurance, Anes, and Anaes. In addition, textbooks on quality assurance in health care, quality improvement texts from business management, and accreditation documents were reviewed. Quality systems in health care are derived from business or industrial models. Study of this field is hampered by poorly defined terminology and jargon. Over the years, many different models have been used in health care, but recent studies have investigated the effectiveness of methods such as Quality Improvement. Many of the systems used by hospitals appear to have been prompted by requirements of accreditation standards. Recently, systems of hospital organization have appeared which link Quality Assurance, Quality Improvement, risk management and utilization management. Despite the confusion created by ill-defined terminology and rapid change in some definitions, anaesthetists need to be aware of the basic models of accreditation requirements.