Regional experience of evaluation of professional practice and quality assurance implementation in Aquitaine.

We report the establishment of a voluntary programme for developing the assessment of professional practice and quality assurance conducted since 1989 in the Aquitaine region of south-west France. This experience, in a region where there are 14,000 hospital beds in about a hundred institutions, has aimed at two objectives: (1) the adoption by the region's health professionals of medical guidelines for good practice and methods for measuring quality and outcomes obtained, by means of university training in evaluation and the conducting of several surveys of professional practice and clinical audits; (2) similar adoption by the regional political, administrative and medical directors of quality assurance procedures defined by an organizational audit concerning the prescription of preoperative tests in the university hospital and in the main public hospitals of the region. The critical impetus that this experience has created, together with other factors related to the political decision-makers and health managers of the region, has led to an operational regional structure for developing clinical evaluation and quality in Aquitaine.