[When the health care inspectorate closes the operating theatres: a case study]

The topic of 'quality of care' is subject to intense interest from the media, the public and the government. One of the key roles of the Dutch Health Care Inspectorate (IGZ) is the supervision and monitoring of quality of care. When the IGZ pays a visit, this generally has many consequences for the hospital concerned.

Following an unannounced inspection of a hospital, the IGZ closed the operating department due to shortcomings in the quality of care. The IGZ and the hospital proved to have different ideas concerning the norms of quality. Using a theoretical framework we have tried to provide some insight into the consequences of this situation.

A hospital comprises a number of different domains each with its own value system (market, governmental and political, societal, medical profession). To prevent these differences standing in the way of good care, we advise all parties to look outside their own domain in order to overcome the boundaries and connect to other domains and value systems.