[The continuous improvement of the health system: results of the phase 1 of the implantation of the Quality Plan in Spain (1986-1992)].

Abstract

The increasing society demands for improved quality in health care are forcing the health care systems to evaluate their organizational performance. Quality activities were initially limited to inspection and final product control, whereas now they are implemented throughout the whole organisation as Total Quality Management. This approach applies specific methodologies which require valid and reliable daily activity data from everyone in the organisation units. A Total Quality Plan for the spanish health care system was set in motion in 1986. From 1986 to 1992 the First Phase of the Plan was carried out: firstly, an appropriate information system was established in order to generate and exploit valid data about activity and cost; secondly a cultural change towards Continuous Quality Improvement was initiated throughout training and implementation of methodologies and tools of Total Quality Management in the National Health Care system institutions. The implementation of a Continuous Improvement general policy as a second phase, requires the explicit commitment of the Health System top management.