[The effectiveness of quality assurance committees in a university hospital]. / Efectividad de los comités de garantía de calidad en un hospital universitario.

Several groups are developing quality assurance activities in the University Hospital Maastricht, The Netherlands. The coordination of these groups to establish a coherent quality system has been set up as follows. The Board for Quality, set up by the Board of Governors in 1990 is constituted by representatives from medical, nursing, education and research departments. This board is in charge of coordinating the activities of quality assurance committees. The Board for Quality conducted a survey to collect information for assessing the extent to which these committees influence the quality of care. A questionnaire was filled in by all members of each committee (n = 162). Several persons participated in more than one committee (121 persons in total), with 82 respondents. After the analysis of results, the chairman and secretary of each committee were interviewed to discuss results. Means to improve the performance of these committees were indicated by the survey, and implemented where necessary. In most cases the activities of the committees proved to be relevant to the quality of care. The survey was useful as a monitoring tool and feedback-mechanism for committees to control their activities.

[Service quality in health care: the application of the results of marketing research]. / La calidad de servicio en la atención a la salud: applicación de resultados de la investigación mercadotécnica.

This paper deals with quality assurance in health care and its relation to quality assurance in trade and industry. We present the service quality model--a model of quality from marketing research--and discuss how it can be applied to health care. Traditional quality assurance appears to have serious flaws. It lacks a general theory of the sources of hazards in the complex process of patient care and tends to stagnate, for no real improvement takes place. Departing from this criticism, modern quality assurance in health care is marked by: defining quality in a preferential sense as "fitness for use"; the use of theories and models of trade and industry (process-control); an emphasis on analyzing the process, instead of merely inspecting it; use of the Deming problem solving technique (plan, do, check, act); improvement of the process of care by altering perceptions of parties involved. We present an experience of application and utilization of this method in the University Hospital Maastricht, The Netherlands. The successful application of this model requires a favorable corporate culture and motivation of the health care workers. This model provides a useful framework to uplift the traditional approach to quality assurance in health care.