Application of the NIAZ frame of reference; impact on a departmental level

The Netherlands Institute for Accreditation of Hospitals generated a general ”quality standard” applicable to the total quality management of a hospital. In addition departmental standards (NIAZ) are used as a frame of reference within their particular section of the hospitals. So two levels of standards (on an institutional and departmental level) are present and mutually tuned. Both levels can either lead towards a departmental accreditation certificate or a total hospital accreditation certificate. This approach represents a potential that will become extremely important in the future. These various levels should assure and assess their independent as well as joined quality to lead to an overall total quality management system. Various systems applied in Dutch health care, such as NIAZ, EFQM (INK), are discussed. Their use in the hospital setting, the application of indicators and the implications at departmental level are evaluated.