Quality measurement and improvement have an image problem. It just isn’t sexy. This is not to say that clinicians aren’t interested in providing excellent care, quite the reverse. Nonetheless, compared with treating patients or research, reflecting on daily practice can seem rather mundane. The lack of time and resources traditionally devoted to the topic, together with a recent emphasis on publishing performance ‘league tables’, have also hampered our proper engagement. In truth, an element of complacency has also held us back. Audit and quality improvement are often regarded as a chore, a box to be ticked or a task to be delegated to junior staff. Inevitably, the fruits of these labours are often superficial, irrelevant, disconnected or even threatening, and contribute to the disenchantment.
Most hospitals still lack effective systems for monitoring and improving the quality of their clinical services. However, this state of affairs must, and is, coming
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