The Dutch public health care system is being transformed in various ways. With an increasing focus on efficiency and consumer driven care, health institutions in The Netherlands are forced to critically evaluate their actions and processes. With recent political developments creating a more liberal health care system, the role of the patient is steadily changing to the one of a demanding consumer, taking more and more control of his or her own choice of care, all for the best price available. In that sense, health care services are forced to negotiate in a complex matrix of insurer, consumer and government, where good and structural quality of care plays a decisive role. But what exactly is quality of care? Who determines the value? Is it possible to create measurable attributes for quality of care?

The deliverance of accountable quality of care requires an operational and functional quality system. This system plays a key role in the evaluation and improvement (Deming’s plan-do-check-act) of process and outcome quality.

To gain an accurate insight in the different aspects of this system, the use of performance indicators can be a useful tool.

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