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Arch Hellen Med, 20(5), September-October 2003, 532-546


Quality issues in medical practice and in health services

Center for Health Services Research, Department of Hygiene and Epidemiology,
Medical School, University of Athens, Athens, Greece

This paper reviews “quality" in medical practice and in the provision of health services. Quality in the health sector can be defined as the provision in an efficient way of necessary and effective health care which satisfies both the clients and health services employees. The main tool for quality assurance and quality improvement is the implementation of the quality cycle. According to the quality cycle, the first step involves the evaluation of the present situation and the identification of problematic areas. The second step comprises with the selection or creation of criteria, standards, guidelines and protocols of good practice, which serve for comparison and for action planning. In the third step measurements are made for the assessment of the existing level of quality which will be targeted for improvement with the actions taken, which constitute the fourth step. The results of these actions create a new situation which is the beginning of a new quality cycle. Traditionally, quality actions dealt with medical and clinical audit with a view to identifying and correcting “poor” quality practices. In recent years quality issues have been intergrated in the new concept of Total Quality Management (TQM) which is focused on the patient, based on measurements and included in every health services activity. Many European organizations have adopted in their management approach the European quality model, which serves also as a basis for evaluation and distinction. For accreditation purposes, most organizations worldwide use the ISO-9000 quality standards.

Key words: Accreditation, Health services, Quality.

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