Practical planning for quality management

Quality management in health care. L Wilson, P Goldschmidt. Sydney: McGraw-Hill 1995 (xcii + 732 pp.). ISBN 0-07-470247-5.

"Quality management" and its close cousins "total quality management (TQM)" and "continuous quality improvement (CQI)" have been frequent buzzwords in business and health sectors worldwide in the 1980s and 1990s. These concepts are more likely to endure than most management fads of this era, as many companies experience real benefits from becoming customer-focused, measurement-based and improvement-driven organisations. The need for ideas that will lead to better quality and productivity in our health system appears self-evident. And yet, as these authors observe, "today there is no Australian hospital that can boast an effective quality management program". Lionel Wilson's experience in the development of quality concepts within the Australian medicopolitical scene is probably unrivalled. In this book, he and Peter Goldschmidt, also a pioneer and an expert in introducing quality management to health care, codify their knowledge and practice; they also review the history and theory of quality management in health services. The book is actually a manual, focusing on the practical steps that need to be followed if that elusive "effective quality management program" is to become a reality in hospitals in Australia. For TQM idealists, "true" quality management is so integrated into an organisation's culture and work that it becomes inseparable from any other aspect of management. Wilson and Goldschmidt recognise that this goal is probably too daunting in practice, perhaps especially so in medical services. Therefore, without abandoning the aim of integrating quality into everyday clinical activities, they have laid out an implementation program that is realistically achievable in the Australian setting. They particularly emphasise medical staff credentialling, patient satisfaction surveys and structured quality review, and describe models of quality management committees and departments that would fit readily into Australian hospitals. Their discussion also covers risk management and legal issues relevant to quality. This book is neither cheap (at $149) nor short, but it is a unique and substantial contribution to the quality movement in Australia, and should therefore be recommended to all institutions and to health professionals with a major interest in quality management. Gerard Cudmore Strategic Planning Manager Pfizer Pty Limited, Sydney, NSW