De Geyndt notes that structural inputs are necessary but not sufficient condition for measuring quality. He proposes a conceptual model based on structure, process and outcome.
Process measures what is actually done to and for the patient in giving and receiving care.
Project design should emphasize process measures and incorporate the philosophy and methods of quality improvement to assess and improve the service delivery processes purposefully and continuously. Outcomes which are the end results of the correct process of patient care and of the timely availability of the necessary inputs may be measured using indicators of mortality, morbidity and functional impairment. Because outcomes can and are often affected by exogenous factors, it is therefore more effective to improve the health care delivery process continously and to ensure the availability of critical inputs.