[From quality assurance to continuous quality improvement in the American health care system. Personal experiences gained through a 3-week educational stay].

We present our personal experience we got during a three week period in the United States studying different quality control programs in the American health care system. Quality Assurance, a control system leaning on inspections, is widespread in the American industry and the health care organizations. W.E. Deming, an economist, developed some decades ago a philosophy to lead any kind of organization more efficiently and successfully. This theory is called CQI, Continuous Quality Improvement. Following Deming's ideas, first the Japanese and then the American industry have made great improvements during the last two decades. Since 1987 American health care organizations are using more and more the tools of the CQI to improve their quality and reduce the rising costs. Visiting nearly twenty different hospitals or institutes, sponsored and organized by "Johnson&Johnson", we could convince ourselves, that the CQI has several advantages in comparison to the traditional quality control or assurance methods.