Abstract

With the introduction of diagnosis-related groups, German hospitals were obliged to develop quality assurance schemes. This article analyses (1) commonly used definitions for quality in health care and (2) their implementation in terms of interventions for improving quality in hospitals. Consequences of current quality assurance practices include advances in objective quality, but also a shift within the culture of medicine towards dividing the treatment of patients into measurable and standardized steps. In contrast to this objective meaning of quality, there is a demand for more patient orientation and for more attention to the subjective quality of treatment which refers to a therapeutic interaction-based notion of quality standards. Besides technical quality standards, there are important quality standards that are being defined in and through interpersonal therapeutic interaction. Good hospital management should, therefore, protect the cultivation of therapeutic interaction in its essentially interpersonal qualities.