The promotion of quality health care, in terms of equal access to care, quality of life and user satisfaction and cost-effective use of resources, is a priority of national health policies and of the World Health Organization. Recommendation No. R (97) 17 of the Committee of Ministers of the Council of Europe stresses the importance of creating policies and structures that support the development and implementation of quality improvement systems and sets out guidelines thereto. The explanatory memorandum describes in detail the procedures necessary for the implementation of quality improvement systems.