Background: Quality programs that step into the intrinsic motivation of healthcare providers (HCPs) are believed to be effective in improving quality of care. The fact that they are not part of an external regulatory or performance management process seems to be crucial. We therefore aimed to develop a quality program based on internal workflows and HCPs feedback.
 Methods: The project took place at the rehabilitation hospital Koningin Elisabeth Instituut (RH-KEI) in Oostduinkerke (Belgium) during the years 2017-2022. A quality coordinator (QC) was appointed who subsequently developed and implemented an interdisciplinary quality program in concordance with the care strategic plan. The quality program was optimized through surveys among patients and caretakers on the one hand and employees on the other. Involved employees were physicians, nurses, physiotherapists, pharmacists and pharmacy technicians, occupational therapists, psychologists, speech therapists and employees of the facility departments (such as maintenance staff).
 Results: The QC had to be an individual that could coach teams and would be trusted by all departments. This person also embodies independence from and neutrality towards staff and management, so HCPs would feel free to discuss any (institutional) hurdles towards quality of care. The developed quality program was subdivided in four domains with three key strategic objectives. This included that (1) RH-KEI ensures a continuous and dynamic improvement of quality of care based on a set of indicators, (2) RH-KEI holds a culture of quality that is actively supported by all involved employees and (3) RH-KEI continuously improves and guarantees patient safety by developing a well-functioning safety management system. The program was first developed in 2017 for the period 2018 up to and including 2022. After five years, quality and safety is embedded in the culture of RH-KEI. Employees are proud of the progress and work together on an integrated quality story. As well, RH-KEI renewed the quality project for the period 2023-2027, with an even greater focus on patient and caretaker participation, care experience, communication and digitalization.
 Conclusion: The active support by all involved employees turned out to be essential to secure the set objectives on the work floor and to make them part of the daily routine.
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