The principles of quality assurance. WHO Working Group.

Attended by physicians, nurses, health economists, biostatisticians and hospital administrators, a WHO Working Group met in 1983 to suggest a strategy for presenting quality assurance to national health authorities, health professionals, the scientific community, and the consumers of health services. The report attempts to answer the following questions: why is quality assurance needed; what are its objectives; how can it be best introduced at national and local levels; what activities should be included in a national quality assurance programme; and how can the quality of services, if found defective, be improved? As rationale for quality assurance, the report describes professional, social and pragmatic motives; as main objectives, it lists public accountability, managerial improvement and facilitation of adoption of innovations. The section on introducing quality assurance identifies basic principles such as developing public support, stimulation of professional curiosity, training students and gaining the institutional administrators to the side of quality assurance. Starting from a three-dimensional matrix of quality assurance, the report discusses the contents, functions and level of organization of national quality assurance mechanisms. Among the strategies for improving quality, the report mentions positive rewards and use of methods of organizational change. The recommendations of the Working Group should facilitate the development of comprehensive systems for quality assurance as a part of the health care delivery system.