BOOKS : Quality assurance A pathway to excellence By Diana NT Sale Macmillan 320 pages £18. 99

This is a wonderful, solid and thorough book, which provides a good basic overview of quality assurance, and makes links to the wide variety of current NHS initiatives.

The introduction of clinical governance, which is still being worked through in the NHS, has, as one of its effects, the gradual integration of areas such as quality, risk management, complaints and audit.

In any trust there will be a cluster of specialists working in these areas, perhaps 20 or more in a large organisation.

For a variety of historic reasons the quality assurance work has often been initiated from within the nursing profession. This book provides a valuable way for others, perhaps from a background in audit, to take advantage of and build on this existing body of work. Some of the tools which have been developed by the nursing profession, such as Monitor, developed in the UK and building on US work, are potentially generic and need to be much more w ide ly understood and available.

Sale starts with a helpful historic overview of quality assurance, which moves rapidly into the NHS changes of the 1990s. Central to the book is the notion of standards and here we find the first of a number of highly detailed, robust and practical checklists.

In addition the other strength emerges - actual examples.

There really is no substitute for seeing a standards statement for, for example, 'Discharge from hospital (elderly care)', and the author is to be congratulated on gaining the necessary permissions.

Subsequent chapters look at total quality management or continuous quality improvement, clinical audit, clinical effectiveness, evidencebased practice and clinical governance. This exemplifies the value of a single author book, for this variety of perspectives are all carefully integrated and sensibly linked together.

The writing is clear, straightforward and smoothly flowing, and you begin to hear the author's individual voice.

The latter part of the book is devoted to a scheme of accreditation for nursing development units developed by the author and the Institute of Nursing at Leeds University.

This has now been extended to practice development units, and the model has been piloted in nursing homes.

This provides a valuable way to look at clinical governance with other agencies and valuable, practical lessons emerge from the pilot experience.

In summary, this book will help to open up quality assurance to others looking at clinical governance, and provide the basis for a better shared understanding of work done and tools developed.