Taylor D
GJW Health Affairs, London.
BMJ. 1996 Mar 9;312(7031):626-9. doi: 10.1136/bmj.312.7031.626.
Since the start of the 1990s the NHS and the clinical professions have made significant investments in quality management in health care, and a plethora of initiatives has been aimed at service improvement. From a patient's perspective the extent to which these exercises have been cost effective is uncertain, although they have certainly involved great effort and enterprise on the part of many clinicians and managers. An important opportunity now exists to integrate this work into the mainstream of clinical and general service management. If clinicians can accept quality management concepts as central to their professional ethos and regulatory structures this could help them to maintain their professional authority and protect them and their patients from imposed decisions based on inadequate understanding of health care costs and benefits.
自20世纪90年代初以来，英国国民医疗服务体系（NHS）和临床专业人员在医疗质量管理方面投入了大量资金，众多举措旨在改善服务。从患者的角度来看，这些举措在多大程度上具有成本效益尚不确定，尽管它们无疑耗费了许多临床医生和管理人员的大量精力和心血。现在有一个重要的机会，可以将这项工作纳入临床和一般服务管理的主流。如果临床医生能够将质量管理概念视为其职业精神和监管结构的核心，这将有助于他们维护专业权威，并保护他们自己和患者免受基于对医疗成本和效益理解不足而做出的强制决策的影响。
