The purpose of this review is to provide the practicing anaesthetist w
ith an historical perspective of quality, a summary of current models,
and an introduction to the expectations of accreditors. Articles were
obtained from an electronic literature search on Silver Platter(R) us
ing the search terms Quality, Quality assurance, Anes, and Anaes*. In
addition, textbooks on quality assurance in health care, quality impr
ovement texts from business management, and accreditation documents we
re reviewed. Quality systems in health care are derived from business
or industrial models. Study of this field is hampered by poorly define
d terminology and jargon. Over the years, many different models have b
een used in health care, but recent studies have investigated the effe
ctiveness of methods such as Quality Improvement. Many of the systems
used by hospitals appear to have been prompted by requirements of accr
editation standards. RecentlY, systems of hospital organization have a
ppeared which link Quality Assurance, Quality Improvement, risk manage
ment and utilization management. Despite the confusion created by ill-
defined terminology and rapid change in some definitions, anaesthetist
s need to be aware of the basic models of accreditation requirements.