[Quality management in a Swiss hospital]

Although there are quite good examples of quality management in Swiss hospitals available (the guidelines of quality management in the Swiss hospital etc.), the distribution of measures of quality assurance in Swiss hospitals is insufficient and focuses more on Hotel services and technical equipment rather than on the care by physicians and nurses. Beginning with Jan. 1, 1998, contracts of quality assurance between health care providers and sponsors have to be presented according to the new health insurance act. These contracts are proofed periodically by a national office. This necessitates a country-wide introduction of statistics (ICD-codes) and computerization. This is currently only in the process of realization. Additionally, hospitals and medical practices already undertake a comprehensive quality control due to local and regional initiatives. The society of Swiss physicians FMH supports mainly three areas: compulsory continuing medical education (80 hours annually, including 50 hours in recognized meetings), the development of guidelines by medical societies, and data collection including the development of a network for measures of quality assurance. The ISO-standard 9000 was changed for health care as ordered by the NAQ (National workshop for quality assurance) and the FMH. It is supposed to be used mainly for the certification of facilities for continuing medical education, perhaps also for the certification of hospitals.