[From quality assurance in health care to its total management].

The health services adopt some methods for quality improvement and quality management from other branches of activities, in particular industry. Health care has naturally its specific features which make it possible to adopt findings in a creative and not merely in mechanical way. The method of quality assurance involves in particular the inspective character of detecting and eliminating different shortcomings, while the method of systematic improvement of the quality and its total management activates in its effort to achieve a high standard of provided services, all workers and the entire organization, integrating medical pretentiousness, effectiveness and efficiency with decentralized responsibility. The total quality management implies a systematic approach and democratic process of quality improvement. The creative approach of workers to the quality of care is based on the comprehensibility and complete acceptance of the objectives of the institution and the obvious and systematic evaluation of all processes and their results. In the submitted paper the author discusses necessary prerequisites and individual steps of implementation of programmes for improving the quality of care, as outlined by experts abroad, and based on the author's findings.