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It is now universally recognized that the individual processes of clinical audit, research and development (R & D) and quality assurance require maximum integration and systematic management if the success of each is to be guaranteed and if true increases in the quality of clinical care are to be delivered to patients. Such achievements are perfectly possible if sound methodologies are developed and implemented in a rigorous and academically-tenable manner. Such an approach can seem complex, confusing and alienating, but is quite essential to success. This volume describes the means by which these changes can be achieved in practice, so that increases in clinical effectiveness, clinical appropriateness and the efficiency of clinical service delivery can be generated and measured quantitatively as well as qualitatively. In addition, the book presents methodologies through which purchasers of health services can effectively utilize a range of clinical outcomes and clinical quality indices. It avoids the jargon and cosmeticism that is often the source of so much frustration to clinicians, health academics and senior managers.The primary market for the book is health care managers, medical practitioners, health services chief executives, medical directors, directors of quality, directors of business and planning in the health services, quality assurance managers, senior nurses and nurse managers. The secondary market is health academics, undergraduate and postgraduate students studying health service management.