Management for Doctors: The importance of quality: sharing responsibility for improving patient care

tional needs should be taken up, and the development of a continuing medical education industry based on uncertain evidence of effectiveness, as has occurred in other countries, should be avoided.Linking audit and peer review to continuing medical education would allow anxieties about the effectiveness of continuing medical education to be addressed, would permit local ownership, and would allow doctors to choose learning methods that both meet their own educational needs and fit in with their personal learning styles.Such a link would avoid the need to introduce sanctions as, with audit as the monitoring instrument, participation and the attainment of satisfactory standards of performance would be documented.The emphasis on local provision would also help to overcome the conflict of interests that might arise when a royal college both approved or accredited continuing medical education programmes and also provided continuing medical education. ConclusionsIt is and always has been a fundamental requirement for any professional to keep up to date in his or her profession.IJke breast milk and a high fibre diet, continuing medical education is without doubt good for use.Why then has activity erupted among those who wish to manage, control, and codify continuing medical education?Britain is rapidly moving down the road, well trodden in other countries, towards a rigid, formalised, and policed continuing medical education industry.Continuing medical education is in danger of becoming a behemoth, a lumbering, unbending monster, and this burgeoning industry is based on assumptions that remain unproved.A shift from centralised to local provision linked to peer review and audit will avoid these hazards.* Making customers' needs a priority for everyone * Defining quality in terms of customers' needs * Recognising the existence of intemal customers and suppliers * Examining the process of production rather than individual performance for explanations of flaws or poor quality * Using sound measurement to understand how to improve quality * Removing barriers between staff and promoting effective team work * Promoting training for everyone * Involving the whole work force in the task of improving quality * Understanding that quality improvement is a con- tinuous process Key point summary * Quality improvement is on the agenda * Total quality management has a role in the NHS * Problems with quality are often the result of flawed processes rather than incompetent individuals * Sound management underpins clinical activity, and the two combined effect improvements in quality * A collective view of care requires input from all relevant professionals * Good, reliable data on the processes of work are vital * Improving quality is a continual process