Journal Article

Bridging the quality chasm: integrating professional and organizational approaches to quality

Marc Berg, Wim Schellekens and Cé Bergen

in International Journal for Quality in Health Care

Published on behalf of International Society for Quality in Health Care

Volume 17, issue 1, pages 75-82
Published in print February 2005 | ISSN: 1353-4505
Published online February 2005 | e-ISSN: 1464-3677 | DOI:
Bridging the quality chasm: integrating professional and organizational approaches to quality

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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.

Keywords: care programs; continuous quality improvement; critical pathways; flow; information systems; patient safety; process redesign; quality indicators; quality of health care

Journal Article.  5338 words.  Illustrated.

Subjects: Public Health and Epidemiology

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