title: Quality management in health care: a 20-year journey.
abstract: In this article, the total quality programme in the Spanish healthcare system (1986-1992) and the subsequent quality improvement steps that have led to definition and implementation of such an integrated framework, seeking a quality management system and patient safety, are discussed.
authors.affiliation: TQM Division, Instituto Universitario de Evaluación Sanitaria, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Ulises
authors.initials: U
authors.lastname: Ruiz
mesh_terms: D000047:Academies and Institutes; D019985:Benchmarking; D017408:Guidelines as Topic; D006739:Hospital Administration / Q000592:standards*; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control; D017146:Models, Organizational; D009313:National Health Programs / Q000458:organization & administration / Q000592:standards*; D011050:Policy Making; D017149:Private Sector / Q000592:standards; D017150:Public Sector / Q000592:standards; D019984:Quality Indicators, Health Care; D012015:Reference Standards; D017751:Safety Management / Q000379:methods / Q000639:trends*; D013030:Spain; D017749:Total Quality Management / Q000379:methods / Q000639:trends*