How to induce physicians to engage in quality assurance activities in a university hospital: a policy.

This article reports on a 3-year quality assurance (QA) support activity in the Assistance Publique-Hôpitaux de Paris, a large university hospital system covering the Greater Paris area. This activity stressed the interprofessional and voluntary character of QA. As well as showing the traditional reservations that usually prevent physicians from embracing QA. French physicians have specific problems with the word "evaluation" that has for them greater monetary than scientific connotations. In addition, the above-mentioned reservations are aggravated by the background culture and career structure of university physicians in France. In spite of these initial difficulties the support programme succeeded in getting QA off the ground in 60 departments in 25 hospitals. The need for a well developed medical information system as an incentive for QA activities in AP is discussed.