Current Western health care practices face the challenge to improve their quality on multiple dimensions simultaneously. This requires new ways to think about how to deliver health care services. A careful and 'flexible' standardization of care into 'care programs', we argue, is central. Yet such standardization is powerless without the application of four additional design principles: a thorough restructuring and delegation of tasks, the application of integrated planning, the use of indicators about the functioning of the care programs, and implementing process-supporting information technology. Vice versa, these additional principles can only function properly when integrated with care programs. We will only be able to improve the safety, effectiveness, patient-centeredness, and timeliness of health care, while reducing costs and improving equity, by integrating professional and organizational approaches to quality. This paper describes a series of interrelated design principles that together depict how future health care delivery could be organized.

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doi.org/10.1093/intqhc/mzi008, hdl.handle.net/1765/71709
International Journal for Quality in Health Care
Health Care Governance (HCG)

Berg, M, Schellekens, W, & Bergen, C. (2005). Bridging the quality chasm: Integrating professional and organizational approaches to quality. International Journal for Quality in Health Care, 17(1), 75–82. doi:10.1093/intqhc/mzi008