Clinical performance and quality health care
-
Clin Perform Qual Health Care · Jul 1993
Review Historical ArticleQuality in anesthesia care: lessons from industry and a proposal for valid measurement and improvement.
Quality anesthetic care is a goal fundamental to our tradition and our training, but defining and measuring quality in anesthesia presents special challenges. Industrial models of quality, especially those so fundamental to the re-emergence of post-war Japan, deserve careful study and are discussed at some length, but they clearly have limitations in understanding quality in anesthesiology. We suggest that most current quality efforts are inherently flawed. ⋯ Third, and perhaps most important, anesthetic processes and outcomes must be reported on a national level. Fundamental to future quality efforts in our specialty, we believe, is the establishment of a protected National Anesthesia Outcome Registry. This article reviews the industrial and medical history of quality, its measurement and improvement, and attempts to apply principles learned over many decades to anesthesiology.