A proposed adaptation of the EFQM fundamental concepts of excellence to health care based on the PATH framework

Paula Vallejo*, Rosa Maria Saura, Rosa Sunol, Vahe Kazandjian, Victoria Ureña, Jordi Mauri

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)


Objective. The use of the European Foundation for Quality Management (EFQM) Model in health care has found that this model is useful in promoting quality improvement, but its use in health care organizations is challenging because being a generic model, it does not cover the clinical aspects or the specifics of this field. For that reason, this article aims to bring the EFQM fundamental concepts of excellence closer to health care, using a specific model as a reference to this field: the Performance Assessment Tool for quality improvement in Hospitals (PATH) conceptual framework, developed by the WHO Regional Office for Europe. Method. A content analysis was performed to independently identify the contents that defined the elements of both frameworks. Then, using defined criteria, two independent researchers compared the contents of the elements of both frameworks. The elements from both frameworks that were equivalent were aggregated. Several experts discussed the aspects with discrepancies between the two comparisons. Finally, the EFQM framework is adapted to health care by adding to those aggregated elements the aspects that were exclusive from one of the models. Results. The EFQM framework has many correspondences to a health care-specific framework. The EFQM-health care-adapted framework has eight quality dimensions, two of them (customer focus and safety) being overlapped with the other six (staff, results orientation, responsive governance, leadership and constancy of purpose, clinical effectiveness, and partnership development). This model also has two methodological dimensions (management by processes and facts and continuous learning; improvement and innovation). Conclusion. This adapted model seems useful for health care organizations, but it needs to be further used to corroborate this preliminary finding.

Original languageEnglish
Pages (from-to)327-335
Number of pages9
JournalInternational Journal for Quality in Health Care
Issue number5
Publication statusPublished - Oct 2006
Externally publishedYes


  • EFQM
  • Quality improvement
  • Theory of quality management
  • TQM


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