Herz
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Standardization is one of the fundamental methods for quality management. Standards describe first requirements for adequate delivery of diagnostic and therapeutic services (e.g. in the format of guidelines and protocols), second they define core data sets for documentation of real clinical outcome and of process and structure quality or third they define normal values (standards in the strict sense) or thresholds for critical parameters. This standardization is increasingly performed by the professional societies in international collaboration. ⋯ In our extended concept, these deviations are in addition symmetrically used to trigger, where necessary, the process of evaluation of the guideline. The often poor acceptance of guidelines should be improved both by integrating them into daily practice and by providing a feedback to the guideline authoring committee. We conclude that standardization activities are now entering into a new era due to increased involvement of physicians, international collaboration, integrated approaches to quality management, and improved computerized tools.