The historical precedents for quality assurance in health care.

The evolution of quality assurance as an essential component of a scientific, objective approach to health care delivery, and its implications for the profession of occupational therapy are presented. A review is made of the economic, ethical, psychological, and legislative forces that have influenced the development of quality assurance over the past century, a development that has seen times of strong emphasis on quality assurance functions, as well as periods of minimal support and, even, obstacles to any activity. Quality assurance standards established by both The American Occupational Therapy Association and the Joint Commission on Accreditation of Hospitals (JCAH) are discussed. Results of commitment to these standards include improved effectiveness and efficiency of health care, better coverage and reimbursement from third-party payors, and greater professional growth. The need for commitment by occupational therapists to the most effective forms of quality assurance is recommended.