A Review of Historical Developments of Quality Assessment in Industry and Healthcare

Alexander Komashie
Systems Engineering Research Group, Brunel University, West London, UK

Ali Mousavi
Systems Engineering Research Group, Brunel University, West London, UK

Justin Gore
The North West London Hospitals NHS Trust, London, UK

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Publicerad: 2008-02-15


ISSN: 1650-3686 (tryckt), 1650-3740 (online)


The quality of healthcare has been a major problem in many Countries for many years. Finding a definition; methods of evaluation; monitoring and improvement have been the major problems that researchers and healthcare practitioners have had to investigate over the years (Idvall et al; 1997).

Donabedian (1966) noted that the quality of healthcare is a “remarkably difficult notion to define.” Based on a definition offered by Lee and Jones (1933); he concludes that the criteria of quality of care are mere value judgements that are applied to aspects of a process called healthcare. Deming (1986) cites and shares W. A. Shewhart’s view that the difficulty in defining quality emanates from the need to translate future requirements of the user into measurable characteristics so that the product or service can be designed and turned out to satisfy the user. Regarding the quality of healthcare; Deming states that a definition is a “perennial problem”. He adds that healthcare quality has been defined in many ways and that each way seems to serve a special type of problem. In spite of this difficulty in defining the concept; there has always been the need to measure and improve quality.

Moreover; it is evident that better quality has been achieved at different levels in different industries or organisations. For example; Young et al (2004); Merry (2004); Laffel et al (1989); and Mohammed (2004) provide evidence that healthcare practitioners can adopt some of the quality improvement techniques in practice in other industrial systems mainly in the manufacturing sector. Currently there are several cases of attempts being made to apply some industrial systems improvement techniques in healthcare (Komashie and Mousavi; 2005; Moore; 2003; Dodds; 2005).

This paper attempts to extract information from a comparative analysis of quality improvement methods in industry and healthcare and to suggest some directions for further study. It is primarily concerned with the general concepts of quality assessment within these industries at various points in time and how these concepts have changed. It must also be noted that there are volumes of publications on quality both in healthcare and industry but this paper is not an exhaustive review of relevant literature. It is however believed that the sources selected for this study are representative of the major trends in quality particularly in the United Kingdom and the United States of America.


Quality improvement; quality methods; industry; healthcare


Baggott; R.; (1998); Health and Health Care in Britain; 2nd ed.; Macmillan Press Ltd.; London; pp 191

Baltussen; R. & Ye; Y. (2006); "Quality of care of modern health services as perceived by users and non-users in Burkina Faso"; International journal for quality in health care : journal of the International Society for Quality in Health Care / ISQua; vol. 18; no. 1; pp. 30-34.

Berenholtz; SM.; Dorman T.; Ngo K.; Pronovost P. J.; (2002); “Qualitative review of intensive care unit quality indicators”; Journal of Critical Care; 17; 1; 1-15.

Berwick; D. M. and Bisognano; M.; (1999); “Health Care Services”; in Juran; J. M. Godfrey; A. B. (ed); Juran’s quality handbook; 5th edn; McGraw-Hill; USA; pp32.1-32.20.

Bull; M. J.; (1992); “Quality Assurance: Professional Accountability via Continuous Quality Improvement”; in Meisenheimer C. G. (ed); Improving Quality: A guide to effective programs; Aspen Publishers Inc; USA; pp 3-20.

Campbell; S. M. ; Braspenning J. ; Hutchinson A. and Marshall M.; (2002); "Research methods used in developing and applying quality indicators in primary care"; Quality and Safety in Health Care; 11; 4; 358-364.

Campbell; S. M.; Roland M. O. and Buetow S. A.; (2000); “Defining quality of care”; Social Science and Medicine; 51; 1611-1625

Che Rose; R.; Uli J.; Abdul M.; Looi Ng K.; (2004) Hospital service quality: a managerial challenge. International Journal of Health Care Quality Assurance; 17; 3; 146-159.

Cooke; L.; (1992); “Computers: Quality assurance applications”; in Meisenheimer C. G. (ed); Improving Quality: A guide to effective programs; Aspen Publishers Inc; USA; pp 197-225.

Deming; W. E.; (1986); Out of the crisis; MIT; USA.

Dodds; S.; (2005); ”Designing improved healthcare processes using discrete event simulation”; British Journal of Healthcare Computing and Information Management; 22; 5; 14-16.

Donabedian; A.; (1966); "Evaluating the quality of medical care"; Milbank Quarterly; vol. 44; no. 3; pp. 166-206.

Dooley; K.; (2001); "The paradigms of quality: Evolution and revolution in the history of the discipline"; Advances in the Management of Organizational Quality; vol. 5; pp. 1–28.

Eldabi; T.; Paul; R. J.; and Young; T.; (2007); “Simulation modelling in healthcare: reviewing legacies and investigating futures”; Journal of the Operational Research Society; 58; 262-270.

Ellis R. and Whittington D.; (1993); Quality Assurance in Health Care; A Handbook; Edward Arnold; Lon

Ferlie; E.B. & Shortell; S.M.; (2001); "Improving the Quality of Health Care in the United Kingdom and the United States: A Framework for Change"; The Milbank quarterly; vol. 79; pp. 281-315.

Fuchs; E.; (1999); “Customer service”; in Juran; J. M. Godfrey; A. B. (ed); Juran’s quality handbook; 5th edn; McGraw-Hill; USA.

Hare; L.; (2003); “SPC: From chaos to wiping the floor”; Quality Progress; July; 2003; available online at

www.asq.org/pub/qualityprogress/past/0703/58spc0703.html (accessed on 20/12/2006).

Hutchins; D.; (1990); In pursuit of Quality. Pitman; London.

Idvall; E.; Rooke L.; and Hamrin E.; (1997); “Quality indicators in clinical nursing: a review of the literature”; Journal of Advanced Nursing; Vol. 25; no. 1; pp 6-17.

Jessee; W. F.; (1981); “Approaches to improving the quality of healthcare: Organizational change”; Quality Review Bulletin; 7; 7; 13-18.

Juran; J. M. (1999); “How to think about quality”; in Juran; J. M. Godfrey; A. B. (ed); Juran’s quality handbook; 5th edn; McGraw-Hill; USA.

Komashie; A.; and Mousavi A.; (2005); ”Modeling emergency departments using discrete event simulation techniques”; Proceedings of the 2005 Winter Simulation Conference; Kuhl; M. E.; Steinger; N. M.; Armstrong; F. B.; and Joines; J. A.; eds.; 2681-2685.

Laffel; G. & Blumenthal; D. (1989); "The case for using industrial quality management science in health care organizations"; JAMA: The Journal of the American Medical Association; vol. 262; no. 20; pp. 2869-2873.

Lee; R. I.; and Jones; L. W.; (1933); The Fundamentals of Good Medical Care; University of Chicago Press; Chicago.

Madhok; R.; (2002); “Crossing the quality chasm: lessons from health care quality improvement efforts in England.

Maguad; B.A.; (2006); "The modern quality movement: Origins; development and trends"; Total Quality Management and Business Excellence; vol. 17; no. 2; pp. 179-203.

Mainz; J.; (2003); "Defining and classifying clinical indicators for quality improvement"; International Journal for Quality in Health Care; vol. 15; no. 6; pp. 523-530.

Merry; M. D.; (2004); “What Deming says”; Quality Progress; Sept. 2004; 37; 9

Mohammed; M.A.; (2004); "Using statistical process control to improve the quality of health care"; Quality and Safety in Health Care; vol. 13; no. 4; pp. 243-245.

Moore S.; (2003); ”Capacity planning – modelling unplanned admissions in the UK NHS”; International Journal of Health Care Quality Assurance; 16; 4; 165-172.

Okes; D. (2006); “Promoting quality in your organisation”; Quality progress; May 2006; Vol. 39; no. 5; pp. 36-40

Ranade W.; (1997); A future for the NHS? Health Care for the Millennium; 2nd ed.; Addison Wesley Longman Ltd.; New York; pp 153

Reid; R. D.; (2006); “Developing the voluntary healthcare standard”; Quality Progress; Nov. 2006; 39; 11; 68-71

Sale; N. T.; (2000); Quality Assurance: a pathway to excellence; Macmillan Press Ltd.; London.

Tavana; M.; Mohebbi; B. & Kennedy; D.T.; (2003); "Total quality index: A benchmarking tool for total quality management"; Benchmarking; 10; 6; 507-527.

Wisniewski; M.; and Wisniewski H.; (2005) “Measuring service quality in a hospital colposcopy clinic”; International Journal of Health Care Quality Assurance; 18; 3; 217-228.

Young; T.; Bailsford S.; Connel C.; Davies R.; Harper P.; and Klein J. H.; (2004); “Using industrial processes to improve patient care”; BMJ Vol. 328; 162-4.

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