[German Society of Pneumology: Recommendations for quality assurance in ambulatory and inpatient pneumologic management. "Quality Assurance in Pneumology" Working Group].

Steps to safeguard quality assurance have always been an inseparable part of any action taken by physicians who are aware of their responsibility towards their patients. Quality assurance can be improved further by introducing additional procedures, some of which were developed by the industry, to ultimately achieve a comprehensive quality management. Of course, additional quality assurance measures involve additional cost and effort, so that the increasingly straitened financial circumstances of the hospitals restricting outpatient and inpatient care services imply a critical assessment and discussion of the pros (efficiency) and cons (cost factors) of such services. The article discusses in particular such procedures that are particularly well suited for application in pneumology. The establishment of "standards" via guidelines and recommendations and their continual updating are basic prerequisites for quality assurance. Many guidelines and recommendations to this effect have been worked out by the pneumological associations. As far as internal quality management in hospitals is concerned, it appears meaningful to delegate quality assurance work to selected supervisory staff members in different spheres of activity (medical care, nursing, hotel services, organisation of workflow) who also keep quality recordes. To establish external quality control of inpatient pneumological care it would be feasible to establish "peer review" techniques assessing random samples of patient records and of the attending rounds, as well as of the results of general inspections of the hospital. Discipline-specific quality indicators and participation in oncological aftercare programmes are also important. In the outpatient sphere, discipline-specific quality circles offer extensive possibilities for effecting quality assurance measures.