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A Journal on Forensic Medicine
Minerva Medicolegale 2002 December;122(4): 209-26
Teamwork in a health care situation. Competencies, errors, responsibilities, insurance cover
An increasing emphasis on standards and the growing awareness of patients and operators have created attention and emphasis around the concept of quality. Terms like audit, peer review, accredidation, ISO 9000, VRQ. Conti-nuous Quality Improvement and risk management that were once completely unknown have now become familiar, but were are also running the risk that the moment a word gains in popularity it loses clarity. Many terms suggest separate, independent phenomena: in reality there exists a similar approach and a common base to alll these initiatives. We have gone through the concepts of institutional and ìprofessional accreditation, of output and outcome indicators, of benchmarking, of personnel management policy and today's target that has just been explored is partnership with the patient for the improvement of the health service. The two main currents of thought were Quality Assurance (bound to the logic of standards) and Conti-nuous Quality Improvement (based on indicators): today we know that they have the same objective and are recognisable as complementary. I the wake of recent authoritative publications, the phenomenon of the error in medicine has been classified as the product of a health system that is not yet orientated towards the management of quality. It therefore becomes necessary to look for clear definitions, knowledge and procedures: the present paper addresses the juridical aspects as well as the forensic, epidemiological and insurance aspects of the medical error and of the ream activity.