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Groene Hart Hospital


The GHZ is the hospital for the approximately 300,000 residents of the Midden-Holland region. The GHZ chooses a personalised approach in its care for patients, tailored to the needs and wishes of the individual. This is also a choice for complete personalised care, which goes further than just treating the illness. The hospital’s staff aims to provide care and attention that start at the front door and go further than the back door of the hospital.

Discover the: Challenge | Solution | Results

Groene Hart Hospital


Perceptive Process has not only helped this Dutch hospital achieve a phased roll-out of ISO9001 certification in Pediatrics and Radiology, but continues to support the standard’s expansion throughout the hospital’s 30 departments. Perceptive Process helps over 2000 employees tame the documentation and bureaucracy that intensive certification initiatives can create, as well as linking Purchasing, ICT and HRM processes.


Healthcare, Human Resources


Workflow & Process Management


Gouda, The Netherlands



Population served



In December 2007, the Groene Hart Hospital (GHZ) was one of the first hospitals in the Netherlands to receive the NIAZ accreditation (The Netherlands Institute for Accreditation in Healthcare) which proved it to be an adequate and safe organisation. When the accreditation expired in December 2011, after a validity period of four years, the hospital had a choice: renew the accreditation or obtain an entirely new quality certification.

The GHZ decided to leave the NIAZ system and switch to the ISO9001 certification. The reason for this choice, according to Daniele Plessius, Quality and Safety Manager at the GHZ, is: “It is becoming increasingly important in healthcare for hospitals to distinguish themselves. In 2007, being NIAZ accredited was still newsworthy. These days 60 to 70 percent of the hospitals have the NIAZ accreditation. That makes it a lot less special.”

Striving for quality care

By switching, Plessius wants every department to obtain the ISO quality certification separately. Every department will be responsible for setting up and maintaining its own quality system. This forces the departments to organise the quality assurance properly, because it risks losing its own ISO certification if it fails to do so. “We want to distinguish ourselves by offering excellent care to our patients,” Plessius says. “At the same time, we also want to show the healthcare insurers that we can deliver reproducible, high-quality care.”

Striving for the highest quality always brings change. If the change is to be successful, it must be supported by everyone. An additional advantage of this certification is that everyone in the department is involved in the quality process. “This means that our quality assurance is not imposed top-down but rather supported bottom up,” Plessius says.


The great thing about Perceptive Process modeling is that you can show the connections between processes at each level in the organization.
Daniele Plessius Quality and Safety Manager

Gaining new insight

Obtaining a quality standard usually takes a lot of time and manpower. But because in 2007, the GHZ was already using Lexmark Healthcare’s business process modeling for the NIAZ accreditation, it can take over the 1,200 modelled processes one by one for ISO9001. “The great thing about Perceptive Process,” says Plessius, “is that you can show the connections between processes at each level in the organisation. Perceptive Process modeling creates layered processes which allow you to look at the process in various ways. This makes it one of the few tools that can do this.”

Plessius has worked with Perceptive Process for many years and has a lot of experience as a process designer. This experience is apparent from the fact that the GHZ now has CCKL (Committee for Quality Control in Healthcare Laboratories), HKZ dialysis (Standardisation of Quality Assessment in Healthcare), a TNO product certificate for infusion technology and an HACCP certificate. “Without a strong quality system and without the right people, this would have been impossible,” Plessius says.

The ISO9001 certification will have a phased roll-out in the departments of the Groene Hart Hospital, starting with the Pediatrics and Radiology departments. There will also be supporting processes in administrative departments, such as IT and HRM. The first trial audit will take place at the beginning of April and, according to Plessius: “it will undoubtedly come with some teething problems.” By using the ‘constant improvement’ according to the method of Deming, the problems will be solved. “We are striving towards obtaining the ISO9001 certification for a minimum of two departments this year,” Plessius says.


It is possible for ISO9001 certification to cause unnecessary bureaucracy. This cannot be blamed on the standard itself. However, due to all the procedures and all the paperwork that this involves, organisations, employees and clients can be affected by this. Plessius wants to prevent that wherever possible. “Our Perceptive Process quality system is flexible and easy to use and has the option of sending digital, HTML reports. Full paper containers are in the past,” says Plessius.

Improving patient service & satisfaction

Another priority at Groene Hart Hospital is providing timely service to patients. When relying on paper-driven processes this was difficult, but with Perceptive Process, Plessius believes the hospital is better meeting patients’ needs and expectations. “Patients look for a hospital that facilitates their wishes as much as possible,” she says. “We like to perform different examinations in one day when we can, meaning that they have to make less trips to the hospital and that they are diagnosed sooner. By linking the processes as closely as possible, we are increasingly able to level off the annoying waiting times.”

Overcoming process management challenges

“The difficulty of real process management is always to get theory in line with practice. Modelling a process does not mean that it will be executed like that. You have to audit the process, you have to evaluate it. All this just takes time. And because we have to cut back on everything these days, time is so precious that it can be difficult to closely scrutinize sometimes. The challenge is to keep delivering the best quality despite the chronic time shortage. I think we are pretty successful in that respect,” says a contented Plessius.

Quality needs time to grow

Twenty years ago, Daniele Plessius started experimenting with the subject of quality in an academic hospital. “It was pretty endearingly amateurish then,” she says. “The software possibilities have changed massively in those twenty years, and my experience has also increased quite considerably in that time. Quality is no longer a hobby. It is now a serious profession. Of course I myself have also changed over the years. I am no longer stomping my feet because a quality standard simply must be obtained within three months. Quality needs time to grow. My team and the Groene Hart Hospital know this and I’m happy with that.”

With Perceptive Process, Plessius will continue to meet the hospital’s quality control needs, helping to ensure that patients get the best possible care and that the hospital maintains its certifications.