In the late 1980s, the United States embarked on what is perhaps a unique experiment: the application of quality improvement (QI) techniques to the delivery of health care. QI undoubtedly has had major success in manufacturing industries where it was first applied.<sup>29 Walton M.   The Deming Management Method New York: Perigee Books (1986). 

Cliccare qui per andare alla sezione Riferimenti</sup> Its application to service industries has had a shorter but nonetheless similarly successful history.<sup>23 Schalowitz J. Total quality management at Motorola: A successful blueprint for manufacturing and service organizations The Journal of Health Administration 1995 ;  13 : 15-23

Cliccare qui per andare alla sezione Riferimenti</sup> QI is a method and set of statistical tools for measuring the stability, variability, and outcomes of a process combined with a management philosophy that encourages each individual to actively participate in a collaborative effort to identify ways to improve the process and its outcomes.

The use of statistics, measurement of outcomes, and collaborative efforts to improve outcomes are also hallmarks of modern medicine; however, within health plans, practitioners may be resistant to the application of efforts to apply QI methods—even as they are deployed to regulate the health care industry itself.<sup>6 Blumenthal D. Quality of care: what is it? N Engl J Med 1996 ;  335 : 891-893  [cross-ref]

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This article explores the interrelationships of QI and accreditation initiatives and the impact these have had on psychiatrists and other behavioral health practitioners. After an introduction to accreditation and QI initiatives in health care, the article focuses on these processes specifically within behavioral health care. Behavioral health has, most recently and dramatically, experienced the paradigm shifts that managed care, accreditation, and QI activities have wrought.