In the mid-1990s, the then Federal Ministry of Health commissioned an analysis of the principles of accreditation and certification of healthcare facilities abroad. The results of this study were published by Swertz et al. (1998). As part of this study, several healthcare facilities emerged that had been experimenting with quality management concepts for some time, including the Cantonal Hospital in Grabs. The Cantonal Hospital Grabs, which serves acute care in the Swiss canton of St. Gallen, provided an important application and analysis field for various quality management concepts in healthcare organizations for several years. These concepts have already been presented from the user's perspective (Möller et al. 2003) and also in a scientific context (Möller et al. 2005).