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Describes the three stages of implementation of a quality assurance programme (preparatory, development of quality assurance structure and process, appearance of quality assurance outcomes). Observes that it is advantageous to implement the programme by providing external support to internal quality assurance efforts. Mentions the way of conducting a formative and a summative evaluation of a programme as well as the factors that influence the effectiveness of a programme

The purpose of this paper is to identify the factors that contribute to the success or failure of quality assurance programs implemented by Israeli managed care health plans.

An in‐depth study of seven quality assurance programs was conducted, comparing successful with unsuccessful ones using the comparative “case study” method. Employing a semi‐structured questionnaire, 42 program directors and professionals in the field were interviewed.

A number of factors associated with the programs' success emerged. Those external to the program included: ongoing management support, resource allocation, information system support and perceived financial benefit for the organization. Internal factors included: leadership, perceived problem's importance, laying the groundwork in the field, involving field staff in planning and implementation and staff motivation.

The study provides insights into ways to encourage the implementation of successful quality assurance programs in the special organizational context of managed care health plans. As the implementation relies heavily on data, one important precondition is the development of computerized information systems to facilitate ongoing data collection. It is also necessary from the planning stage to take into account organizational factors that affect success.