You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

The Governance of Quality Management in Dutch Health Care: New Developments and Strategic Challenges

Maarse, J. A. M. PhD; Ruwaard, D. PhD; Spreeuwenberg, C. PhD

Quality Management in Health Care:
doi: 10.1097/QMH.0b013e31829a6bef
Original Articles

This article gives a brief sketch of quality management in Dutch health care. Our focus is upon the governance of guideline development and quality measurement. Governance is conceptualized as the structure and process of steering of quality management. The governance structure of guideline development in the Netherlands can be conceptualized as a network without central coordination. Much depends upon the self-initiative of stakeholders. A similar picture can be found in quality measurement. Special attention is given to the development of care standards for chronic disease. Care standards have a broader scope than guidelines and take an explicit patient perspective. They not only contain evidence-based and up-to-date guidelines for the care pathway but also contain standards for self-management. Furthermore, they comprise a set of indicators for measuring the quality of care of the entire pathway covered by the standard. The final part of the article discusses the mission, tasks and strategic challenges of the newly established National Health Care Institute (Zorginstituut Nederland), which is scheduled to be operative in 2013.

Author Information

Department of Health Services, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands (Drs Maarse, Ruwaard, and Spreeuwenberg).

Correspondence: JAM Maarse, PhD, Department of Health Services, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands (

The authors declare not to have received any funding for this research.

The authors declare no conflicts of interest.

© 2013Wolters Kluwer Health | Lippincott Williams & Wilkins