Trends in quality management.

The history of quality control in the clinical laboratory dates at least to 1950. The last 20 years have seen an increasing interposition of regulators that has focused much quality management activity on inspection and fault finding. Recently, the emphasis has turned from monitoring the process within the laboratory to application of indicators as measures of outcome. Most recently, the industrial example of continuous quality improvement offers an opportunity for reduction of costs and improvement of quality in an atmosphere of increasing competition and cost containment. Such an approach offers the opportunity to provide cost-effective, efficient health care for Americans as an alternative to government management.