According to german federal law (SGBV) all hospitals have to implement an internal quality management. That does not necessarily imply accreditation but there is a growing interest in different models of accreditation as part of a marketing strategy. International concepts of accreditation (EFQM, DIN ISO 9000:2000) in general as well as for healthcare specifically are decribed. The german KTQ((R)) (Cooperation for Transparency and Quality in Hospitals) integrates international concepts. It is a voluntary approach to accreditation for hospitals specifically, which is in probation at present and will probably be available for all hospitals in 2002. KTQ((R)) is developed and financed by umbrella associations of the statutory health insurers, the German Hospital Federation, and the German Medical Association. Partners are the German Nursing Care Council and an organization of church held hospitals. Key element is a self-assessment tool based on a detailed catalogue of criteria. This catalogue is also a guideline for external assessment over several days by an interdisciplinary peer-commission of experts. Accreditation will be valid for a period of three years. KTQ((R)) is described in detail in the article.