background Quality systems have become an important and widely used method of monitoring and improving the quality of care in mental health care. However, little is known about the impact of these systems on the daily practice of care.
aim To determine and explain the impact of quality systems.
method A combination of qualitative (focus groups, document analysis, interviews) and quantitative (questionnaire, literature analysis) data collection and analyses based on different theoretical perspectives.
results There are many quality systems available, while the impact on the practice of care is limited. Many systems are unknown and are not used or used inadequately. The lack of impact can be explained by role uncertainty and mistrust in the sector. The fact that certain systems are used can largely be explained by the individual preferences of professionals.
conclusion The current deployment of quality systems is very inefficient. There is no common definition of quality and the quality information from the systems is complex. This complicates the application of quality information. In addition, there is a great deal of mistrust towards the sector, which means that systems are used for control rather than for quality improvement.