title: Bridging the quality chasm: integrating professional and organizational approaches to quality.
abstract: 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.
authors.affiliation: Institute of Health Policy and Managrment, Erasmus University Medical Centre, Rotterdam, The Netherlands. M.Berg@bmg.eur.nl
authors.forename: Marc
authors.initials: M
authors.lastname: Berg
authors.forename: Wim
authors.initials: W
authors.lastname: Schellekens
authors.forename: Cé
authors.initials: C
authors.lastname: Bergen
mesh_terms: D003695:Delivery of Health Care; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D010346:Patient Care Management; D032024:Personnel Delegation; D011216:Practice Management, Medical / Q000458:organization & administration / Q000592:standards; D011364:Professional Practice / Q000458:organization & administration* / Q000592:standards; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D017749:Total Quality Management