Voorwaarden voor een sectorbreed op kennisverspreiding gebaseerd verbeteringsprogramma in de Nederlandse ziekenhuiszorg.

To improve the quality of hospital care the Dutch Ministry of Health is experimenting with a multilevel quality collaborative. The program 'Sneller Beter pijler 3' (SBp3) strives at improving patient safety, patient logistics, the position of patients and the professional quality of medical specialists. In a period of three years the program makers will be running series of 12 Breakthrough and process redesign based projects combined with a Leadership & Organizational Development program (L&O) in 24 hospitals. They assume that the remaining 80% of Dutch hospitals will automatically adopt the methods tested by their predecessors in an effort to obtain similar results.In this article we examine whether the program theory corresponds with determinants identified in the literature. In a variety of studies the parts constituting SBp3 are being recognized as success factors. In practice, however, the success of the program as whole will depend on the final course and contents of the L&O-program and the presence of the right incentives. The latter is to make sure that the parties within the hospitals and the change agents involved, behave in accordance with the program theory. This is far from certain since SBp3 is implemented in a complex environment where hospitals are confronted with regulated competition and transparency on the one hand, the exchange of knowledge on the other. (aut.ref.)