[Quality circles as a strategy of a medical care quality assurance program at the Perinatology National Institute].

The present article shows the methodology of implantation of a quality guarantee program of medical attention through quality circles at the National Institute of Perinatology and it's results. Among them emphasize the following: organization's structure effects. The optimum on resources in it's own process of attention on the satisfaction of the patients and in the learning implicated in the adaptation of the technology to the hospital environment and the characteristics of a different culture from which that technology emerged. The project, conceived as investigation-action, was advised by Public Health Investigation Center and was created with the purpose to secure that the organized conditions under which the medical attention are given were those permitting to raise the quality as much in the among personal dimension as in the technical, through the participation of the personnel directly responsible of the services given. This led to the use of quality circles as participant technical of quality control and as main quality guarantee program of medical attention. Seven stages can be identified in the implantation of the quality assurance program using the quality circles: 1) to elaborate the proposal document and work protocol; 2) negotiation; 3) drawing of a guide for the elaboration of a quality guarantee manual; 4) selection the point of starting; 5) elaboration of the quality guarantee manual by service; 6) to operate the quality circles; 7) evaluation of the program. This experience has demonstrated it's feasible using the quality circles as fundamental components of a quality guarantee program of medical attention and permits to secure that, in general, it is possible to use this technology in the health services.