Organizing for quality and safety in health care-the Norwegian case

The aim of this paper is to describe the organizing of the Norwegian system for patient safety and quality improvement. The paper reports results from a pilot study of the Norwegian health care system. Data collection has been conducted through a triangulation of semi-structured interviews and document analysis. We have performed 20 semi-structured interviews with informants representing organizations and institutions on macro, meso, and micro level. Organizing for quality and safety in the Norwegian context strongly relies on state institutions and self regulation as part of the external governance system. In the local governance system internal control is the main mechanism in organizing for quality and safety. The effort to improve organization of quality and safety is increasing at different system levels in the Norwegian case. However the meso and micro level still lack resources resulting in improvement efforts prone to priority issues and lack of enthusiasm.