title: The impact of redesigning care processes on quality of care: a systematic review.
abstract: BACKGROUND
  This literature review evaluates the current state of knowledge about the impact of process redesign on the quality of healthcare.
  
  
  METHODS
  Pubmed, CINAHL, Web of Science and Business Premier Source were searched for relevant studies published in the last ten years [2004-2014]. To be included, studies had to be original research, published in English with a before-and-after study design, and be focused on changes in healthcare processes and quality of care. Studies that met the inclusion criteria were independently assessed for excellence in reporting by three reviewers using the SQUIRE checklist. Data was extracted using a framework developed for this review.
  
  
  RESULTS
  Reporting adequacy varied across the studies. Process redesign interventions were diverse, and none of the studies described their effects on all dimensions of quality defined by the Institute of Medicine.
  
  
  CONCLUSIONS
  The results of this systematic literature review suggests that process redesign interventions have positive effects on certain aspects of quality. However, the full impact cannot be determined on the basis of the literature. A wide range of outcome measures were used, and research methods were limited. This review demonstrates the need for further investigation of the impact of redesign interventions on the quality of healthcare.
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands. j.vanleijen@maastrichtuniversity.nl.
authors.forename: Janneke E
authors.initials: JE
authors.lastname: van Leijen-Zeelenberg
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.
authors.forename: Arianne M J
authors.initials: AMJ
authors.lastname: Elissen
authors.affiliation: Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Grube
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.
authors.forename: Arno J A
authors.initials: AJA
authors.lastname: van Raak
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.|Scientific Center of Care and Welfare (Tranzo), Tilburg University, Tilburg, The Netherlands.|Department of Family Medicine, Free University of Brussels, Brussels, Belgium.
authors.forename: Hubertus J M
authors.initials: HJM
authors.lastname: Vrijhoef
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Bernd
authors.initials: B
authors.lastname: Kremer
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.
authors.forename: Dirk
authors.initials: D
authors.lastname: Ruwaard
mesh_terms: D057189:Checklist; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D017063:Outcome Assessment, Health Care; D010043:Outcome and Process Assessment, Health Care; D058996:Quality Improvement; D011787:Quality of Health Care / Q000458:organization & administration / Q000592:standards*; D012107:Research Design