[Quality circles in rehabilitation clinics. What has been effective in general practice?].

Within the framework of their quality assurance programme, the German statutory pension funds in 1994 and 1995 required over 400 rehabilitation hospitals to develop structures permitting to establish comprehensive quality management programmes. In particular, they asked that these hospitals should establish quality circles. Structured information could be gathered from 380 hospitals at the end of a pilot phase. According to this information, 233 hospitals conduct a total of 558 quality circles. However, only 23.5% of these quality circles fulfil the criteria of a well-structured quality circle. Another 34.7% of the reported activities can, in a broader sense, be considered as activities that might be helpful in developing Total Quality Management (TQM) systems, whereas 41.8% account for more routine activities such as floor meetings etc. A detailed analysis of the documented information revealed that a high proportion of quality circle participants are recruited from leadership positions. From a subject matter perspective, quality circles still focus on their conceptualization. Taking into consideration the large number of hospitals, the introduction of quality circles can be considered quite successful.