Improving the quality of emergency medicine care by developing a quality requirement framework: a study from The Netherlands.

Background: In The Netherlands, mainly inexperienced physicians work in the ED on all shifts, including the evening and night shifts, when no direct supervision is available. In 2004 a report of the Dutch Health Care Inspectorate revealed that quality of care at Emergency Departments (EDs) was highly variable. Based on this report and international studies showing significant potential for quality improvement, stakeholders felt the need to improve the quality of EM care.

A new approach to the tradeoff between quality and accessibility of health care.

Introduction: Quality of care is associated with patient volume. Regionalization of care is therefore one of the approaches that is suited to improve quality of care. A disadvantage of regionalization is that the accessibility of the facilities can decrease.

Dutch healthcare reform: did it result in better patient experiences in hospitals? A comparison of the consumer quality index over time.

Background: In 2006, the Dutch hospital market was reformed to create a more efficient delivery system through managed competition. To allow competition on quality, patient experiences were measured using the Consumer Quality index (CQI). We study whether public reporting and competition had an effect on the CQI between 2006 and 2009.

How reliable is your hospital? A qualitative framework for analysing reliability levels.

Objective Many approaches and methods have been developed to reduce errors in the healthcare delivery process and to increase patient safety. One of the approaches suited to improve patient safety is reliability theory. This paper adds a qualitative dimension to the application of reliability theory in hospitals.