[Conceptual approaches in quality evaluation, quality promotion and quality assurance]

Ten conceptual approaches make up most of the basis for attempts to deal with quality in healthcare. Quality assessment, quality approvement, and quality assurance are related to the instrumental categories for dealing with quality. At first glance, outcome analysis seems to be most logical. However, the process of healthcare-delivery is of considerable importance and should not be neglected in favor of outcome studies. Accreditation seems promising for obtaining about compliance with standards which serve as a certain degree of guarantee for the prevention of problems. Standards are most prominently connected with structure. With the help of guidelines the process of providing care can be improved. Indicators related to process and outcomes may serve as "flags" for problems. Without continuous evaluation, studies quite often result in no direct contribution to quality improvement and quality assurance.