Tailor-made quality systems in healthcare

At present many healthcare organizations are being pressed by national governments or client groups to develop and implement quality systems. Unfortunately, not much is known about the development and implementation of these systems in healthcare organizations. There still are definition questions to be answered and it is not clear in which way a quality system can be outlined and which outline is most effective in a particular situation. In practice, many healthcare organizations adopt ideas from industrial quality management and develop ISO 9000 based quality systems, which are only useful in relatively stable situations. In this paper a typology of healthcare processes is developed on the basis of input and throughput characteristics, following the literature on professional quality systems and service systems. The typology is tested and illustrated by a few case studies. From this typology, on the basis of logic, suggestions have been deduced for tailor-made quality systems in a general hospital setting. The main point of these systems is an examination, treatment and nursing plan with a timescale. Control is executed on the basis of performance indicators for groups of patients.