The impact of the Flanders Quality Model (FlaQuM) on staff and patient/kin perceptions of quality: a multi-centre longitudinal study

Background The Flanders Quality Model (FlaQuM) was developed to strengthen hospitals’ internal capacity for quality improvement through a multidimensional and multistakeholder approach encompassing patients, kin and healthcare professionals. FlaQuM-Quickscan is a validated instrument that measures perceived quality multidimensionally from a multi-stakeholder perspective. However, their responsiveness to changes in perceived quality over time has not yet been evaluated. Methods A longitudinal observational study was conducted in 15 Flemish healthcare organizations (12 acute hospitals, two rehabilitation centers, and one psychiatric center) that disseminated the FlaQuM-Quickscan in 2022 (T1) and 2025 (T2). The bipartite instrument FlaQuM-Quickscan measures ‘Healthcare quality for patients and kin’ (part 1), scored by patients/kin and professionals, and ‘Healthcare quality for professionals’ (part 2), scored by professionals. The mean score changes, statistical significance, and the FlaQuM Improvement Score (FIS), a measure of improvement relative to the available room for improvement, were calculated for all quality domains. Results A total of 5,286 patients/kin and 6,782 professionals participated at T1, compared with 11,389 patients/kin and 7,142 professionals at T2. Significant improvements were observed across all quality domains in all the questionnaires (all p < 0.001). For Part 1, the mean FIS was 27.4% and 23.9%, as scored by patients/kin and professionals, respectively. For Part 2, the mean FIS was 29.4%, as scored by professionals. Professions also demonstrated the largest absolute improvements, particularly for the quality domains ‘partnership and co-production’, ‘accessible and timely care, ’ ‘person-centered care,’ ‘resilience’ and ‘dignity and respect.’ Relational domains consistently demonstrated strong improvement, whereas ‘eco-friendly care’ showed the greatest variability and occasional negative changes. Conclusions Following one FlaQuM cycle, perceived quality improved significantly across all measured quality domains and stakeholder perspectives. FlaQuM-Quickscan demonstrated sensitivity to change over time and provided a practical approach for monitoring multidimensional quality improvement. Although substantial improvement has been achieved, considerable progress remains, particularly in system-level domains.