Brief historical synopsis of quality management in health care

Ca. 2000 BC - Babylon: Hammurabi's Code of Laws proscribes drastic punishment (execution and mutilation) of the treating doctor for mistreatment. The judgement of a positive / negative treatment result limited itself to clear-cut criteria that could be checked by lay people (death, injury, worsening of the illness). The laws appear to base themselves on 1000-year-old texts of Sumerian origin.

Ca. 2000 BC to ca. 1750 AD - Refusal of administration for untreatable patients in the ancient world - Egypt, Greece, India, Rome - during the European middle ages and until the new age as far as preservation of,  "prestige," and the, "benevolence," of medical pratice.

Since ca. 1750 - Regular autopsies. Introduction of abduction protocols in the spirit of research.

1847 - Semmelwels' deductive method for the recognition of childbed fever and motivation for hygiene following an intuitive quality assurance programme (Paradigma).

1910 - Presentation of the first audit by Codman (USA).

1915 - Flexner develops a structure analysis programme for use in hospitals.

1951 - Founding of the Joint Commission on Accreditation of Hospitals (JCAH) based on the ideas of Flexner and Codman.

1952 - Lembcke develops the current Medical Audit.

1953 - PSRO quality assurance programme (USA).

1963 - Founding of the, "Stichting Medische Registratie," in the Netherlands.

1975 - First perinatal inquiry in Bavaria.

1990 - The, "White Paper," allows the broad establishment of quality assurance programmes in England within 3 years.

1993 - SGB V. §§ 135 ff. Legal requirement for quality assurance for doctors and hospitals in Germany and their expansion in the following years.

2002 - Hospitals can apply for the official quality seal developed by the, "Co-operation for Transparency and Quality in the Hospital (KTQ®)".