Country experience in organizing for quality: Chile.

This article presents an overview of the Chilean program for assuring health service (HS) quality. The National Program for the Evaluation and Improvement of Quality (EMC) was established by the Ministry of Health (MOH) in 1991. The aims were to raise awareness about the importance of quality in HS delivery; to develop a structure for supporting quality; to achieve improvements in quality of health care and service delivery; and to improve patient satisfaction. During 1991-94 EMC received technical assistance undertook to develop quality assurance (QA) capacity and to motivate health workers to engage in QA activities. One full-time staff member at the national level provides training and technical support to the countrys 29 HS facilities. Quality Committees at the HS level operate within 79% of the countrys 29 facilities. HS entities are encouraged to develop their own policies and action plans. Quality monitors at the local level were trained by MOH staff. Over 6500 health professionals and 615 quality monitors were trained in QA methods. The central office of QA control now has a new role in regulation. The office reviews existing laws decrees regulations norms and protocols that affect quality of care. It is studying how to appoint groups of experts to develop norms in specialized areas. Over 400 QA improvement projects were undertaken during 1991-96. The MOH sponsors a National QA Conference and identifies October as Quality Month for focused activities. External technical assistance ended in 1994.