1. National Quality Policy in the Netherlands Cordula Wagner, PhD Emmy Sluijs, PhD Mirjan Geurts, MA

2. Governmental Policy in the 90s Policy changes: more competition and less regulations in health care Target 31 of WHO: member states should have effective mechanisms to ensure quality of patient care April 1989 first conference on a national and comprehensive quality care policy June 1990 second conference held in Leidschendam

3. Providers Insurers Patients Government Three parties together

4. Key agreements I Primary responsibility for quality of care lies with providers Criteria of care has to be developed Internal quality systems Publication of data for quality assessment Providers must allow external review Insurers responsible for reviewing the efficiency and organisation of care

5. Key agreements II Patient organisations responsible for reviewing the culture/organisation of care Criteria for assessing quality of care must be included in contracts between provider and insurer Assessment of patient complaints Assessment of patient opinion

6. 5 Quality Acts Acts reflect the new vision of quality and the focus on patients Acts are the backbone of quality control policy by the Ministry of Health, Welfare and Sport

7. Care institutions Professional workers Patients The care institutions quality act Clients Right of Complaint Act Participation Act Medical Treatment Contracts Act The individual health care professions act

8. released in April 1996 idea: institutions develop own quality control policy the act requires health care organizations to provide care that is effective, efficient and patient- oriented organizations must improve and assure the quality of care systematically (quality systems) accountability by annual quality report Care institutions quality act

9. State-of-the-art 1995 and 2000 Stage Quality System19952000 Orientation2% 2% Preparation 26%29% Implementation 59%64% Establishment (iso)13%5%

10. Quality management activities Quality policy and documents –quality working plan, annual report, quality manual Human resources management –training staff, feedback, Proces control/practice guidelines Continuous improvement –satisfaction research, internal audit Patient participation