title: A measuring instrument for evaluation of quality systems.
abstract: OBJECTIVE
  To develop an instrument for provider organizations, consumers, purchasers, and policy makers to measure and compare the development of quality systems in provider organizations.
  
  
  METHODS
  Cross-sectional study of provider organizations using a structured questionnaire to survey managers.
  
  
  METHODS
  The Netherlands.
  
  
  METHODS
  Provider organizations of six health care fields: primary health care, care for the disabled, mental health care, care for the elderly, hospital care and welfare care.
  
  
  METHODS
  Existence of quality assurance and quality improvement activities.
  
  
  RESULTS
  The study presents a survey instrument for assessing the quality assurance and improvement activities of health care provider organizations and the developmental stage of quality systems. The survey instrument distinguishes five focal areas for quality improvement activities and four developmental stages. The study also reports data on the reliability and validity of the survey instrument.
  
  
  CONCLUSIONS
  The instrument is reliable, easy to administer, and useful across health care fields as well as different kinds of organizations. Developing quality systems provide a common language across all parts of the health care sector. By assigning the activities to focal areas and developmental stages the instrument gives insight into the implementation of quality systems in health care. Comparable information on quality assurance activities increases the accountability of providers. Because of the efficient (not time consuming) approach, the instrument complements existing accreditation reviews.
authors.affiliation: NIVEL, Netherlands Institute of Primary Health Care, Utrecht. c.wagner@nivel.nl
authors.forename: C
authors.initials: C
authors.lastname: Wagner
authors.forename: D H
authors.initials: DH
authors.lastname: De Bakker
authors.forename: P P
authors.initials: PP
authors.lastname: Groenewegen
mesh_terms: D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D006801:Humans; D009426:Netherlands; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care / Q000592:standards*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards