[Quality assurance and standardized measures--a critical discussion]

The debate about quality and quality assurance has a long tradition in the market economy. New in the Federal Republic of Germany, however, is the debate about "quality" in the human services sector: in medical and nursing care, in hospitals and the community, in the health service. This discussion presents practising professionals, politicians and scientists with a number of unsolved problems. This is especially so in defining quality but also in developing, implementing and evaluating appropriate instruments of quality assurance. Quality is far more than what is intended by legislation-economy, productivity and competition- and often conflicts with these expectations. As a consequence, the process of discussion about defining quality turns out to be vague and contradictory rather than systematic, especially since quality cannot be seen as a static component but must be explored as a dynamic element. It is high time to start a critical debate about the concept of quality and current methods of quality assurance.