Goals and reality of quality circles in outpatient care in Germany

: In Germany's outpatient care, quality circles are strongly encouraged as a tool for peer review in order to implement quality assurance and management in daily practice. This paper presents an overview of the status of implementing quality circles in outpatient care. The main features of successful quality circles are described in terms of conditions, structures, and methodological approach. The objectives of quality circles are outlined, and it is discussed to which extent the quality circle concept is established. Recommendations for further developments of quality circles are drawn from this analysis.