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Describes a methodology for measuring standards of patient care available on wards. The quality assurance ward audit is a self‐contained package developed as a management tool to maintain and wheŕe necessary improve quality standards on individual wards. Describes the main features of the package, together with the audit process. These have been designed with practicality, ease of use and consistency of application in mind. Outlines the roles of assessor, ward staff and patients in the audit. Stresses the importance of feedback to staff, and the use of the ward audit as a motivator. Describes the mechanisms for using the audit as part of the management process, not just a one‐off audit event, and outlines some of the positive achievements resulting from use of the quality assurance ward audit.

Describes the process by which an NHS provider Unit sought to make quality assurance and improvement a shared concern of professionals and managers. Development of a quality assurance strategy and related action plans pulled together existing quality initiatives in the Unit and set new initiatives in an agreed framework for organizational development. Thus the strategy filled the gap between a statement of organizational values and detailed quality auditing practices at the sharp end. Through the active involvement of professional staff and managers in multidisciplinary and multi‐level project groups, the facilitated processes of strategy making, dissemination and implementation led to significant learning by and development of staff and managers and an unanticipated spill over of energy, enthusiasm and commitment throughout the organization.

IT IS AN AXIOM that engineers never stop learning. Every fresh job is a fresh challenge that must be met and overcome.