European countries fourmainmodels for the assessment of quality of healthcare services
are used. These are the adoption of quality standards International Organization for
Standardization (ISO), accreditation patterns healthcare specific, visits by external
experts (peer assessment) and finally the EFQM approach. The latter is also the most
generic among the four identified approaches. The different models reflect the original
purpose from which they were generated that are, respectively: professional performance
(visits of external experts), healthcare services delivery (accreditation), management
systems (EFQM) and quality systems (ISO). During the last two decades, the four models
have converged towards standards that include more peculiar aspects such as the
organization, management and clinical performance (Shaw, 2000).