8/17/2019 19. the Role of External Assessment in Improving
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International Journal for Quality in Health Care 2000;
Volume 12, Number 3: p. 167
Editorial
The role of external assessment in
improving health care
The common conclusions are that voluntary and
statutory This issue of the International Journal
for Quality in Health Care agencies should be actively
co-ordinated for consistency andfocuses on the use of external
systems for improving thereciprocity, that consumers should be
prominently involved,organization and delivery of health
services.that national programmes should be comparable in-Ideally
these systems are characterized by explicit, validternationally,
and that the standards, processes and resultsstandards, by reliable
assessment processes and by com-of external assessments should be
transparent and freely plementary mechanisms for implementing
improvement. Foraccessible to the public.the purpose of this
debate, we have generally excluded systems
Can systems, in any country, which were designed to which
are aimed primarily at clinical practice or training, or
support voluntary self-improvement, migrate to meet
in- which are statutory inspectorates for the purpose of l
icensing creasing governmental demands for transparency,
consistency health care facilities (including radiation, fire,
hygiene and theand public accountability? In posing this question,
I wouldgeneral safety of the public and staff ).like to thank the
European Commission and all of thoseMost of the papers in this
issue emerged directly from acolleagues in Europe and around the
world who contributed3-year research project, funded by the
European Commission,to the ExPeRT project and to this issue of the
Journal.into external peer review techniques (ExPeRT). This
identified
two industrial models which have been applied to health careC.
D. Shaw [the ‘Excellence’ model, comparable to Baldrige Awards
in the
Programme Director, CASPE ResearchUSA, and the International
Organization for StandardizationLeader, European research project
‘ExPeRT’(ISO)] and two models developed within health care (ac-
creditation and peer review – ‘visitation’). Each of these
was
examined in relation to the politics and organization
of Referencesnational health services and in terms of their
methodology,
particularly the validity of standards and reliability of the1.
Australian Business Excellence Framework Healthcare
Advisory assessment process.
Group. A Comparison of Quality Programs. Sydney:
AustralianSome papers were invited to respond to the generalQuality
Council, 1999. ISBN 1 875544 76 3.conclusions of the project from
commentators in other
2. National Expert Advisory Group on Safety and Quality
incountries around the world. Other papers were invited
to Australian Health Care. Report. 1998.
www.health.gov.au/review specific questions (such as the use of
numericalabout/cmo/report.docperformance measures in external
assessment) which had not
been dealt with in detail by the research project. 3.
Scottish Office. Acute Services Review (Carter Report).
Edinburgh:Inevitably, these papers are either describing or
responding Scottish Office Publications, 1998.
www.scotland.gov.uk/lib-
rary/documents5/acuteto the situation in Europe, but they also
contribute to aglobal debate. Within the past 2 years,
nat ional reports from 4. President’s Advisory Commission on
Consumer Protection and
Australia [1,2] Scotland [3 ] and
the USA [4] have examined Quality in the Health
Care Industry. Quality First: Better Health and
questioned the contribution of external mechanisms not
Care for all Americans , 1998.
www.hcqualitycommission.gov/
final/only to internal development, but also to public
accountability.
© 2000 International Society for Quality in Health Care
and Oxford University Press 167
