Abstract
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 ofaccreditors. 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 illdefined terminology and rapid change in some definitions, anaesthetists need to be aware of the basic models of accreditation requirements.
Résumé
L’objet de cette revue consiste à fournir à l’anesthésiste une perspective historique de la gestion de la qualité, un résumé des modèles courants et un aperçu des exigences des accréditeurs. Les documents ont été obtenus à partir d’une recherche électronique sur Silver Platter® en utilisant les termes Quality, Quality assurance, Anes* et Anaes*. De plus des manuels traitant de la gestion de la qualité dans les services de santé, des textes sur l’amélioration de la qualite dans l’administration des affaires et les documents d’accréditation ont été consultés. Les systèmes de gestion de la qualité sont dérivés de modèles financiers et industriels. Les études dans ce domaine sont entravées par une terminologie et un jargon mal définis. Depuis plusieurs années, en soins de santé, on utilise plusieurs modèles, mais des études récentes ont examine l’efficacité de méthodes telles que l’amélioration de la qualité. Plusieurs des systèmes hospitaliers sont déterminés par les standards d’accréditation. Des systèmes d’organisation hospitalière d’origine récente relient ensemble la gestion de la qualité, l’amélioration de la qualité, et la gestion du risque. Malgré la confusion causée par une terminologie mal définie et les variation rapides de définition, les anesthésistes doivent connaître les modèles de base et les exigences des accréditeurs.
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Eagle, C.J., Davies, J.M. Current models of “quality” — an introduction for anaesthetists. Can J Anaesth 40, 851–862 (1993). https://doi.org/10.1007/BF03009257
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DOI: https://doi.org/10.1007/BF03009257