Organisational innovation: 4A, a generic model for reengineering and optimization of the hospital processes

In this paper, we propose the clinical itinerary as an innovative approach to deal with the hospital complexity problems. We define also the requirements of the new CQI model generation in order to adapt continuous quality improvement (CQI) to hospital processes. In this direction, we will propose a "4A" model as a generic tool allowing the applying of CQI on a clinical itinerary by its modelling, its reengineering, its piloting by the indicators and the organisational perpetuation of the improvement logic. We illustrate a generic character of our CQI model by a real life application in the Andre Vesale Hospital (CHU de Charleroi/Belgium) on the Medical Laboratory Process