QUALITY IN

HEALTH CARE

Editor: Fiona MossAssociate editors: Richard Baker, Pam Garside, Alison Kitson, Michael Maresh,Steve Nixon, Richard ThomsonTechnical editor: Diana Blair-FishEditorial assistant: Ruth Clarke

EDITORIAL BOARD N BarberH BuchanD CostainN DicksonJ Firth-Cozens

R FitzpatrickA FraterJ GabbayA GiraudJ Girvin

R GrolB HausslerA HopkinsD KerrV Maehle

N MckechnieH McKennaM McNicolK McPhersonJ Muir Gray

C NormandM RiggeC ShawJ WadsworthC WestEditor, BMJ

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ISSN 0963 8172

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CommentWDiary/Quality Quotes/Notes

evaluation of audit is the same asresearching audit or even auditing audit.Confused? These two reports really canhelp.The authors' analysis of the future

direction of audit in the NHS may not beuniversally shared, although their list of

key issues is commonly accepted. That the

authors have been able to draw togetherand usefully distil the evidence andmethodologies used to evaluate auditbodes well for the next stages of their ownevaluative study. Whatever yourperspectives or involvement in audit, the

further reports promised should make notonly interesting reading but willundoubtedly inform future policy andaction.

BILL ENNISMedical Audit Facditator

DIARY

11 AprilLondon: Royal Society of Medicine Jointmeeting with Forum on Quality in HealthCare and the Section of Measurement inMedicine. League tables for health care?Further details from Mrs Nicole Taub,Royal Society of Medicine, 1 WimpoleStreet, London W1M 8AE (tel 071 2902987; fax 071 355 3197).

17-22 AprilLondon: Imperial College. World Con-gress of Occupational Therapists eleventhinternational congress. Developing oppor-tunities. Session themes: children,community care, developing aspects ofworks in occupational therapy, education,elderly people, management, mentalhandicap/le ig difficulties, physicaldisability, psychiatry/mental illness, andtechnology. (C390 approximately, exclu-ding accommodation.) Contact Congress

Secretariat Conference Associates andServices Ltd, WFOT, 55 New CavendishStreet, London WIM 7RE (tel +44 71486 0531; fax +44 71 935 7559).

20-24 JuneMaastricht: University of Limburg,Summer University Health Sciences andMedicine. Quality assurance in healthcare. A working course focusing on qualitymanagement in health care institutionsand on assessment of performance (eitheror both options may be taken). ContactAnnie Simon, Summer University HealthSciences and Medicine (University ofLimburg PO Box 616, 6200 MDMaastricht, The Netherlands (tel 31 43881552; fax 31 43 881552).

22-24 JuneLondon: First Euroquan conference onquality and nursing practice. Passport toquality. Contact Karen Waterman,Conference Manager, Passport to Quality,Viking House, 17-19 Peterborough Road,Harrow, Middlesex HAl 2AY (tel 081423 1066).

NOTES

The Eli Lilly National Clinical AuditCentre was set up in May 1992 as aresource to medical audit advisory groups,health authorities, and others involved inaudit. One of its current projects entailsdeveloping a package of audit protocolsfor primary health care teams, which canbe used for standard setting andmonitoring a practice patient's charter.Guidelines will be developed for standardsetting in primary care, covering the mainareas of access to health care (that is,waiting times); contacting the surgery (bytelephone); and comments, suggestions,and complaints. The centre would beinterested to hear from anyone who hascompleted an audit in any of these areas,particularly with regard to settingappropriate standards. Contact DavidFrench, Eli Lilly National Clinical AuditCentre, Department of General Practice,University of Leicester, Leicester GeneralHospital, Gwendolen Road, LeicesterLE5 4PW (tel 0533 584873 fax 0533584982).

QUALITYQUOTES

Perfection is attained by slow degrees; itrequries the hand of time.

Loyal and efficient work is a great cause,even though it may not be immediatelyrecognised, ultimately bears fruit -

JAWAHARLAL NEHRU

It is reasonable to have perfection in our

eye that we may always advance toward it,though we know it can never be reached- SAMUEL JOHNSON

The question "who ought to be the boss?"is like asking "who ought to be the tenorin the quartet?" Obviously, the man whocan sing tenor - HENRY FORD

Amusing or erudite items relating toquantity - including examples of "qualityspeak", cartoons, etc are welcomed forpublication and should be addressed to theeditor

"if you could just fill out this 30 pagequestionnaire for us Mrs Green, we'll getround to seeing you shortly...."

-J urArae

279

Quality in Health Care 1993;2:280-281

Referees

The journal would like to thank the following people for their support in acting as referees of submitted papers.

S AdamP C AdamsL AhmedI AnnanG S AnthonyD ArmstrongI A BakerP BanfieldN BarberM J BardsleyA BartonD N BatemanA K BatesG BatstoneM BatstoneA BaughanN R BealeE BeckD BellM N BeltonJ BennettD BerrowA BerlinR BhopalN Black0 BolesD de BonoM BoultonA BowlingC BradleyJ E BrazierA BrewisJ BrittonS La BrooyD BrownC BucknallP BurneyJ P BurnieC St J BuxtonM CalnanA CampbellR Carr-HillS ChaplinA J CharltonM L ChiswickJ ChristieJ M ColesA F ColverG A CookC CooperA CoulterJ R Cove-SmithH V CrockI CrombieD CunninghamG CunninghamA CuschieriS W D'SouzaM DancyA DavidH DaviesG C Davies

M DaviesS DaviesK DavisonA J DawsonJ DayP DayG DelaceyR DentS DenholmF DiffordP DonnaiA C DowellL DoyalP DuffC DunnS EbrahimM EcclesJ M EddlestonP EmersonD EwingtonG FaderA FarmerE FarmerR FawdryK C H FearonM FeherA FergusonL FickerJ Firth-CozensR FitzpatrickD FlemingJ FothergillF G FowkesA FranksA FraterP FreelandT FryerS S FurnissJ GabbayA GaleL GaminaraE GarraldaJ GarrowP GarsideM GillP T GillS GillamP GilliesM GoldacreI S GrantJ M GrayC S GrayE S GreenR GreenbaumR M GreenhalghS G GreenhoughA GrenfellD GriffithJ Grimley EvansJ GrimshawR GrolA Haines

M H HallD HallsM HamiltonS M HamiltonJ HamptonC R HankeyN J N HarperC M HarrisD HarrisD HarrisonJ T HartG HarveyI HaslockK HatchP HibbsN HicksA HiggettI HigginsonR HillmanR HillsonS HiltonC HindA HomerA HopkinsR HomeG HoughtonN HumbleC HumphreyB HurwitzA HutchinsonK HydeD IrvineP JacksonA JacobyM R JacynaB JarmanD JefferiesP JefferysD JenkinsH M L JenkinsR JenkinsC JenkinsonD JewellM JoffeD JohnsonR W G JohnsonR JohnsonM JohnsonC JollA JonesJ JonesM JonesR H JonesS JonesE JoyceD KeeleyR KellyT KempleD KerrP KinnersleyR J E KirkmanW Kirrup

V KitchenJ C KitchenerS KramerZ H KrukowskiF KurerM F LakerM K LakhaniS LambD LavoieM LawrenceM LawsonR LeaveyP LelliottS LentonM LevyS LightmanT LissauerK LittleB LivesleyI M R LowdonG LucasM J MackieR MadhokD MantF MartinG MawerK McCannD McCreaS McIvorM McKeeH McKennaR K McKinleyC McManusM McNicolK McPhersonM M McQueenA C MillarG T MillarJ D MillarH MillingtonA MordueC MorrellR J MortonS MurphyJ A M MurrayK M V NarayanD E NealC NormandT C O'DowdP A OwenD B PaintinF R PajakC PantinD ParkinM PartridgeC M PatersonD L H PattersonP N PlattR PorterA PollockP PresleyM Pringle

280

Referrees

P PritchardS ProctorE J PughA PurseyA E RaffleM D RawlinsS ReesD S ReidJ RhodesC RichardsJ RichardsM RigbyM RiggeJ E RobbN RobertsonJ RobinsonM RobinsonR H RobsonH RodgersM RolandJ RomS RowlandS N RumseyI RussellD RutaA Saha0 Samuel

M SchachterH SchmiedenT P SchofieldD L ScottM W SeifE SeinP L SelbyT SenskyS ShafiJ ShanksC ShawT SheldonD SheridanC SingerM SingerS SingletonL SirelingP SladeR SlaterC SmithF SmithG SmithT SmithJ SpencerJ SpibyC StanbridgeD Steedman

P J SteerD StevensB StockingA StotterF M SullivanG P SummerfieldG TanA R TannerA TattersfieldR TaylorD ThomasT A ThomasK ThomsonA ThompsonG ThornicroftJ P TobyT TreasureA B TulloD TunbridgeL Turner-StokesT UsherwoodR VicaryP S VinallC VincentB WadeD WadeJ Wadsworth

S A WalkinshawI W J WallaceK WalsheT WaterstonE M WatkinC J WatkinsA C H WatsonH M S WatsonR WatsonR WestP WhiteM WhiteM WhitfieldD WilkinP WilkinsonA WilsonB WilsonR G WilsonJ WoodhouseC WoodroffeP D WrightA YardumianD W YatesA YoungJ Yudkin

281

282

QUALITY IN HEALTH CARE VOLUME 2:

AAVITSLAND P. Use of laboratory testing for genitalchlamydial infection in Norway, 91

AHMAD N see BAHRA A et alALPIN V. Public health medicine and public health dentistry

information resource: correspondence, 276AmouRETTi M see GIRAUD A et al

BAHRA A et al. Perceptions of audit reactivity: correspondence,65

BAIN J see SuHTvAN F and BAIN JBAKER R. Audit and development in primary care, London,

February 1993: meeting report, 144Audit and the team: an interview with the Adelaide

Medical Centre team, 191Avedis Donabedian: an interview, 40Quality of care in family medicine/general practice,WONCA/SIMG Congress, The Hague, Netherlands,June 1993: meeting report, 208

BARBER N. Improving quality of drug use through hospitaldirectorates: editorial, 3

see also COTTER S et alBARKER J see MADHOK R et alBARLOW DH see HILL AM et alBARTON JR see GULLIFORD MC et alBATCHELOR A see CORBETT EL et alBERROW D see HUMPHREY C and BERROW DBHOPAL R see THOMSON R and BHOPAL RBLACK N, SANDERSON C. Day surgery: development of a

questionnaire for eliciting patients' experiences, 157BLACK N et al. Comparison of NHS and private patients

undergoing elective transurethral resection of theprostate for benign prostatic hypertrophy, 11

Day surgery: development of a national comparative auditservice, 162

BOOK REVIEWSBOND S, BALOGH R, SIMPSON A, QUINN H, DUNN J,WILKINSON A et al. An analysis of instruments and toolsused in psychiatric nursing audit, 1993, 207

Communication audit tools, 207FIRTH-COZENS J. Audit in mental health services, 1993,276

GIRAUD A. Evaluation medicale des soins hospitaliers,1992, 66

HAINES A, HURWITZ B, editors. Clinical guidelines. Reportof a local initiative, 1992, 143

HOUGHTON G, SPROSTON B. Forty practical auditexamples - a review, 1993, 278

HUMPHREY C, HUGHES J. Audit and development inprimary care, 1992, 143

LoT-T DA, editor. Designing a fair and reasonable basicbenefit plan using clinical guidelines. California PublicEmployees' Retirement System, 1992, 68

McIvER S. Obtaining the views of users of primary andcommunity health care services, 1993, 206

Making medical audit effective, 208Medical audit tools, 208Moving to audit, 208OVRETVEIT J. Health service quality - an introduction to

quality methods for health services, 67PRINGLE M. Change and teamwork in primary care, 1993,207

PRITCHARD P, PRITCHARD J. Developing teamwork inprimary health care: a practical workbook, 1992, 67

ROLAND M, COULTER A, editors. Hospital referrals, 1992,142

SHAW C. Specialty medical audit, 1992, 277WILLIAMS HS, WEBB AY. Outcome funding: a new

approach to public sector grantmaking (UK edition),1992, 277

BOROwITz M see SHELDON TA and BOROWITZ MBOUFFORD JI. US and UK health care reforms: reflections on

quality, 249BOURNE HM see GULLIFORD MC et alBOYLE G see GiuAM S et alBRIT-rIS S see EBRAHIM S et al

AUTHOR INDEX

BRONZITE N see BAHRA A et alBUCHAN H. Clinical guidelines: acceptance and promotion:

editorial, 213BUCKINGHAM JK see GARRATT AM et alBULL DJ see HILL AM et alBULL PD. Jennifer's ear: airing the issues: correspondence, 66

CARR-HILL RA see LONG AF et alCARROLL L. Medical Audit Advisory Group, Birmingham,

October 1993: meeting report, 278CASPARIE AF. View from the Netherlands, 138CHARNOCK FM see HILL AM et alCOHEN H see TAN GBT et alCOLES J see WALSHE K and COLES JCOLVER AF see GILLAM SJ and COLVER AFCORBETT EL et al. Patients' awareness of streptokinase

treatment after thrombolysis for acute myocardialinfarction: correspondence, 206

COTTER S et al. Hospital pharmacists' participation in auditin the United Kingdom, 228

Pharmacists and prescribing: an unrecorded influence:editorial, 75

CROMBIE I, DAVIES H. Routine data: a resource for clinicalaudit? correspondence, 276

CROMBIE IK, DAVIES HTO. Missing link in the audit cycle:viewpoint, 47

DAVIDSON G, GILLIES P. Safe working practices and HIVinfection: knowledge, attitudes, perception of risk, andpolicy in hospital, 21

DAVIES H see CROMBIE I and DAVIES HDAVIES HTO see CROMBIE IK and DAVIES HTODE HAAN R et al. Use of health care services after stroke,

222DERENNE Y see GIRAUD A et alDIXON P see LONG AF et alDOWNES SM see SUDESH S et alDUNLEAVEY J see JONES R et al

EBRAHIM S ET AL. Long term care for elderly people, 198EDGAR MA. Improving quality of health care: correspondence,

142EVANS J, HATCH K. Advancing day surgery. North East and

North West Thames Regional Health Authorities andNHS Management Executive, London, January: meetingreport, 69

FRATER A. Healthy outcomes. Health Service Journalconference, London, November 1992: meeting report,69

see also SHANKS J and FRATER AFREEMANTLE N et al. Brief interventions and alcohol use,

267Managing depression in primary care, 58see also SHELDON TA et al

GABBAY J see TAN GBT et alGARRATT AM et al. Towards measurement of outcome for

patients with varicose veins, 5GILL M. Purchasing for quality: still in the starting blocks?,

179GILL P see FREEMANTLE N et alGILLAM S et al. Cooperation or conflict over child health

surveillance? Views of key actors, 83GILLAM SJ, COLVER AF. Preschool child health surveillance,

129GILLIES P see DAVIDSON G and GILLIES PGILLMER MD see HILL AM et alGIRAUD A et al. View from France, 274GLASIER A see PENNEY GC et alGLICKMAN M see GILLAM S et alGODFREY C see FREEMANTLE N et alGOLLEDGE S. Second national symposium on the future of

medical audit in general practice, Chepstow, March1993: meeting report, 208

283

GRAHAM N see EBRAHIM S et alGRIFFITH D. Setting standards: correspondence, 142GRIMSHAW J, RUSSELL I. Achieving health gain through

clinical guidelines: developing scientifically validguidelines, 243

GULLIFORD MC et al. Selection for oesophagectomy andpostoperative outcome in a defined population, 17

HALL R see LONG AF et alHAL IDAY HL. Introducing new cost effective treatments into

the NHS. Surfactant treatment for premature babies:who cares enough to pay? viewpoint, 195

HARWOOD R see EBRAHIM S et alHATCH K see EvANs J and HATCH KHAUSSLER B. View from Germany, 63HIGGINSON I. Advanced cancer: aiming for the best in care,

112HILL AM et al. Evaluating a policy of reduced consultant

antenatal clinic visits for low risk multiparous women,152

HOWELL S see BAHRA A et alHUMPHREY C, BERROW D. Developing role of medical audit

advisory groups, 232HUNTER D see BLACK N et al

JACKSON IJB see MADEJ TH et alJEWELL D. Setting standards: correspondence, 142JONES R et al. Problems with implementing guidelines: a

randomised controlled trial of consensus management ofdyspepsia, 217

JouLE N. Involving users of health care services: movingbeyond lip service: editorial, 211

KARMI G. Equity and health of ethnic minorities, 100KEE F. Referrals for coronary angiography in a high risk

population, 87KITCHEN V see MAIN J et alKOGAN M, REDFERN S. Clinical audit project: correspondence,

66KON OM see BAHRA A et alKR'uKowsKl ZH see GARRATT AM et al

LAWRENCE D see MILNE R and LAWRENCE DLAYTON A see MCNICOL M et alLearning tools, Clinical audit training package, 1992, 144LEWIS-JONES S see MAIN J et alLIMBURG M see DE HAAN R et alLONG A see FREEMANTLE N et alSHELDON TA et al

LONG AF et al. The outcome agenda: contribution of the UKclearing house on health outcomes, 49

see also FREEMANTLE N et alLYDEARD S see JONES R et al

MCCI ELAND DBL see PENNINGTON SJ et alMCCORMACK B. The developing role of community

hospitals: an essential part of a quality service: reviewarticle, 253

MACDONALD LM see GARRATT AM et alMCDONNELL PJ see SUDESH S et alMACKAY K. Factors influencing default at a hospital

colposcopy clinic: correspondence, 65MCKEE M. Routine data: a resource for clinical audit? 104:

correspondence, 276see also COTTER S et al

MCNICOL M et al. Team working: the key to implementingguidelines: editorial, 215

MCPHERSON K see BLACK N et alMADEJ TH et al. Assessing introduction of spinal anaesthesia

for obstetric procedures, 31MADHOK R et al. An audit of distribution and use of

guidelines for management of head injury, 27MAIN J et al. Purchasing care for people with HIV infection

and AIDS, 53MAUETTE P see GITRAun A et alMASON J see SHELDON TA et alMASON JM see FREEMANTLE N et alMENDELOW AD see MADHOK R et alMILNE R, LAWRENCE D. Prospective audit comparing

ambulatory day surgery with inpatient surgery fortreating cataracts: correspondence, 65

MORDUE A see MADHOK R et alMORGAN G see MCNICOL M et alMoss V see MAIN J et alMURPHY WG see PENNINGTON SJ et al

NORMAN IU see REDFERN SJ et al

OLIVER S see REDFERN SJ et al

PARR CW. Quality, the patient's charter, and primary care:editorial, 151

PENNEY GC et al. Agreeing criteria for audit of themanagement of induced abortion: an approach bynational consensus survey, 167

PENNINGTON SJ et al. Clinicians' satisfaction with a hospitalblood transfusion service: a marketing analysis of amonopoly supplier, 239

PETTIGREW M see BLACK N et alPINCUS T see VINCENT CA et alPOLLOCK A see VICKERS N and POLLOCK APROCTOR SJ. Why clinical research needs medical audit:

editorial, 1PRYDE V see BAHRA A et al

REDFERN S see KOGAN M and REDFERN SREDFERN SJ et al. Assessing quality of nursing care, 124REES J see CORBETT EL et alRICHARDS C see FREEMANTLE N et alRIGBY MJ see WILLIAMS JG et alRIVERMEAD SPECIALTY TEAM, see WADE DTROBERTS R see WILLIAMS JG et alROBINSON PR. Role of the Clinical Standards Advisory

Group: correspondence, 65ROMAIN K. Advanced cancer: aiming for the best in care:

correspondence, 206RUSSELL I see GRIMSHAW J and RUSSELL IRUSSELL IT see GARRATT AM et alRUTA DA see GAR.RATT AM et al

SANDERSON C see BLACK N and SANDERSON CBLACK N et al

SCURR JH see VINCENT CA et alSHAH R see CORBE-TY- EL et alSHANKS J, FRATER A. Health status, outcome, and

attributability: is a red rose red in the dark? viewpoint,259

SHELDON TA, BOROWITZ M. Changing the measure ofquality in the NHS: from purchasing activity topurchasing protocols: editorial, 149

SHELDON TA et al. Cholesterol screening and cholesterollowering treatment, 134

see also FREEMANTLE N et al; LONG AF et alSLACK R see BAHRA A et alSMITH GD see SHELDON TA et alSONG F see FREEMANTLE N et alSHELDON TA et al

SPENCER J. Audit in general practice: where do we go fromhere?, 183

SUDESH S et al. Audit of patients' awareness of ophthalmicdiagnoses, 175

SULLIVAN F, BAIN J. General practice audit: view fromScotland, 204

TAN GBT ET AL. Referral of patients to an anticoagulantclinic: implications for better management, 96

TAYLOR FC see TAN GBT et alTEMPLETON A see PENNEY GC et alTHOMSON R, BHOPAL R. Improving quality of health care: the

role of public health medicine, 35THOMSON RG see MADHOK R et alTOMALIN DA see REDFERN SJ et al

VAN DEN Bos GAM see DE HAAN R et alVAN DER MEULEN J see DE HAAN R et alVICARY R see CORBETT EL et alVICKERS N, POLLOCK A. Incompleteness and retrieval of case

notes in a case note audit of colorectal cancer, 170VINCENT CA et al. Patients' experience of surgical accidents,

77

284

WADE DT. Services for people with stroke, 263WALKER M. Clinical audit 1993 - collaborating for quality in

the management of clinical care. NHS ManagementExecutive Clinical Audit Conference, Nottingham,February 1993: meeting report, 145

WALLIS C see EBRAHIM S et alWALSHE K, COLES J. Medical audit: in need of evaluation,

189WATSON P see FREEMANTLE N et al

WEBB J see FREEMANTLE N et alWHEATLEY RG see MADEJ TH et alWILLIAMS JG et al. Integrated patient records: another move

towards quality for patients? editorial, 73WILSON J see MADEJ TH et alWOODROFFE C see GILLAM S et al

YUDKIN PL see HILL AM et al

285

QUALITY IN HEALTH CARE VOLUME 1:

Abortion, induced, agreeing criteria for audit of management,approach by national consensus survey, 167

Accidents, surgical, patients' experience, 77Adelaide Medical Centre team, interview, 191AIDS, purchasing care for people with, 53Alcohol use, and brief interventions, 267Antenatal clinic visits, consultant, reduced, for low risk

multiparous women, policy evaluation, 152Anticoagulant clinic, referral of patients, implications for

better management, 96Appropriate health care, meaning, 117Audit

activity, perceptions: correspondence, 65clinical, routine data as resource, 104: correspondence,276

and clinical research, needs: editorial, 1cycle, missing link: viewpoint, 47general practice

view from Scotland, 294where do we go from here?, 183

hospital pharmacists' participation, United Kingdom, 228medical

advisory groups, developing role, 232in need of evaluation, 189

of patients' awareness of ophthalmic diagnoses, 175and the team, interview with the Adelaide Medical Centre

team, 191

Benign prostatic hypertrophy, elective transurethral resectionof prostate, NHS/private treatment compared, 11

Blood transfusion service, hospital, clinicians' satisfaction,marketing analysis of a monopoly supplier, 239

Cancer, advanced, aiming for the best in care, 112:correspondence, 206

Case notes, incompleteness and retrieval, case note audit ofcolorectal cancer, 170

Cataracts, ambulatory day/inpatient surgery compared:correspondence, 65

Child health surveillance, cooperation or conflict, views ofkey actors, 83

Chlamydial infection, genital, use of laboratory testing,Norway, 91

Cholesterol screening and cholesterol lowering treatment,134

Clinical audit project: correspondence, 66Clinical guidelines, acceptance and promotion: editorial, 213Clinical Standards Advisory Group, role: correspondence, 65Colorectal cancer, case note audit, incompleteness and

retrieval of case notes, 170Colposcopy clinic, factors influencing default at:

correspondence, 65Comment, 70, 145, 209, 278Community hospitals, developing role, essential part of a

quality service: review article, 253Coronary angiography, referrals in a high risk population,

87Correction, 145Cost effective treatments, new, introducing into the NHS,

surfactant treatment for premature babies, who caresenough to pay? viewpoint, 195

Data, routine, resource for clinical audit? 104: correspondence,276

Day surgerydevelopment of national comparative audit service, 162development of questionnaire for eliciting patients'

experiences, 157Dentistry, public health, information resource: correspondence,

276Depression, managing in primary care, 58Diary, 70, 146, 210, 279Donabedian, Avedis, an interview, 40Drug use, improving quality through hospital directorates:

editorial, 3

SUBJECT INDEX

Dyspepsia, consensus management, randomised controlledtrial, 217

Elderly people, long term care, 198Ethnic minorities, equity and health, 100

France, view from, 274

General practice, auditview from Scotland, 204where do we go from here? 183

Genital chlamydial infection, use of laboratory testing,Norway, 91

Germany, view from, health care system since unification,63

Glue ear, airing the issues: correspondence, 66Guidelines

clinical, acceptance and promotion: editorial, 213key to implementing, team working: editorial, 215problems with implementing, randomised controlled trial

of consensus management of dyspepsia, 217

Head injury, management, distribution and use of guidelines,audit, 27

Health careimproving quality: correspondence, 142reforms, US and UK, reflections on quality, 249services

involving users, moving beyond lip service: editorial,211use after stroke, 222

Health gain, achieving through clinical guidelines, developingscientifically valid guidelines, 243

Health status, outcome, and attributability: viewpoint, 259HIV infection

purchasing care for people with, 53safe working practices: knowledge, attitudes, perception of

risk, and policy in hospital, 21Hospital pharmacists' participation in audit, United

Kingdom, 228

Integrated patient records, another move towards quality forpatients? editorial, 73

Interventions, brief, and alcohol use, 267

Jennifer's ear, airing the issues: correspondence, 66

Laboratory testing for genital chlamydial infection, Norway,91

Long term care for elderly people, 198Low risk multiparous women, evaluating policy of reduced

consultant antenatal clinic visits, 152

Medical auditadvisory groups, developing role, 232in need of evaluation, 189see also Audit

Meetings reports, 69, 144, 208, 278Multiparous women, low risk, evaluating policy of reduced

consultant antenatal clinic visits, 152Myocardial infarction, streptokinase treatment after

thrombolysis, patients' awareness: correspondence, 206

Netherlands, view from, 138NHS, /private treatment compared, transurethral resection of

prostate, 11Nursing care, assessing quality, 124

Obstetric procedures, introduction of spinal anaesthesia,assessing, 31

Oesophagectomy, selection, and postoperative outcome in adefined population, 17

Ophthalmic diagnoses, patients' awareness, audit, 175

286

Patients' awarenessof ophthalmic diagnoses, audit, 175of streptokinase treatment after thrombolysis for acute

myocardial infarction: correspondence, 206Patient's charter, quality, and primary care: editorial, 151Pharmacists

hospital, participation in audit, United Kingdom, 228and prescribing, an unrecorded influence: editorial, 75

Pharmacy, and quality of drug use: editorial, 3Premature babies, surfactant treatment, who cares enough to

pay? viewpoint, 195Preschool child health surveillance, 129Primary caremanaging depression, 58quality, and the patient's charter: editorial, 151

Private patients, /NHS compared, transurethral resection ofprostate, 1 1

Prostate, transurethral resection, NHS/private treatmentcompared, I 1

Public health medicineand public health dentistry information resource:

correspondence, 276role in improving quality of health care, 35: correspondence,

142Purchasing activity to purchasing protocols, changing the

measure of quality in the NHS: editorial, 149Purchasing protocols, from purchasing activity to, changing

the measure of quality in the NHS: editorial, 149Purchasing for quality, still in the starting blocks? 179

Qualitychanging the measure in NHS, from purchasing activity to

purchasing protols: editorial, 149in health care, Avedis Donabedian interview, 40of health care, improving, role of public health medicine,

35: correspondence, 142the patient's charter, and primary care: editorial, 151

Quality quotes, 71, 146, 210, 279

Records, patient, integrated, another move towards qualityfor patients? editorial, 73

Research, clinical, and audit, needs: editorial, 1

Safe working practices, and HIV infection: knowledge,attitudes, perception of risk, and policy in hospital, 21

Scotland, general practice audit, 204Setting standards: correspondence, 142Spinal anaesthesia for obstetric procedures, introduction,

assessing, 31Standards, setting: correspondence, 142Streptokinase treatment after thrombolysis for acute

myocardial infarction, patients' awareness:correspondence, 206

Strokeservices for people with, 263use of health care services after, 222

Surfactant treatment for premature babies, who cares enoughto pay? viewpoint, 195

Surgical accidents, patients' experience, 77

Team working, key to implementing guidelines? editorial,215

Thrombolysis for acute myocardial infarction, streptokinasetreatment after, patients' awareness: correspondence, 206

Treatments, cost effective, new, introducing into the NHS,surfactant treatment for premature babies, who caresenough to pay? viewpoint, 195

United Kingdomclearing house on health outcomes, contribution, outcomes

agenda, 49health care reforms, reflections on quality, 249

United States, health care reforms, reflections on quality,249

Varicose veins, towards measurement of outcome, 5