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First published in 1999, this eclectic collection of papers examines quality management in health care from a variety of standpoints. Managers, health care professionals and patients all have valid - but often differing - perspectives on the nature of quality, its creation and maintenance. This book explores these perspectives, beginning by asking such fundamental questions as 'Is health care a business?', 'How should health services be designed?' and 'What is quality of care?'. Subsequent chapters then address the practicalities of measuring and improving health care quality. The chequered history of clinical audit is exposed in the UK (essentially the Plan-Do-Check-Act cycle familiar to quality improvement specialists), and lessons are drawn for managerial action needed to increase the impact of such activities. These lessons have wider relevance to all involved in promoting the principles of continuous quality improvement (CQI). In addition, exploration of the growing role of performance indicators raises important issues about their meaningfulness and instrumentality in effecting real change. Improving clinical quality is now at the top of the agenda for many health systems. This book reviews the challenges faced and the tools available to meet them. It should prove valuable to a wide range of health care stakeholders interested in broadening their understanding of this rapidly developing field.