Table 1.

Major studies and steps in the development of SHF

Study area (year)	Type of study	Sample	Main results
Hospital, part 1 (2004/2005)	Explorative survey	30 SHO, 20 SH clearinghouses	Participative development of criteria
Hospital, part 2 (2004–2006)	Model project, implementation study	Two hospitals in Hamburg	Testing and final formulation of eight criteria; two hospitals awarded ‘quality seal’
Hospital, part 3 (2008–2010)	Model project, implementation study	31 hospitals in NRW, 17 finishing the process	Process pattern and guidelines for becoming self‐help friendly; 17 hospitals awarded distinction
Public health service (2009–2011)	Delphi method, interactive identification and approval of quality criteria	16 public health departments	10 quality criteria approved by workshop of public health doctors at their annual conference 2011
Ambulatory care (2009–2011)	Model project, implementation study	Nine practices, individual MDs from 8 specialties	Six criteria approved and introduced into quality management manual for doctors in NRW
Rehabilitation (2010–2013)	Model project, implementation study prepared by focus group of 14 SHR	Two rehabilitation hospitals	Five criteria successfully tested; two hospitals awarded distinction; introduction in one national accreditation system planned