Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Shared decision making in the United States: policy and implementation activity on multiple fronts.
Shared decision making in the United States has become an important element in health policy debates. The recently passed federal health care reform legislation includes several key provisions related to shared decision making (SDM) and patient decision support. Several states have passed or are considering legislation that incorporates SDM as a key component of improved health care provision. ⋯ Numerous professional organizations are advocating for SDM and social networking efforts are increasing their advocacy as well. Policy makers are intrigued by the potential of SDM to improve health care provision and potentially lower costs. The role of shared decision making in policy and practice will be part of the larger health care reform debate.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Benchmarking: how to measure outcome quality at the comprehensive oncology centre in Stuttgart].
Quality-controlled documentation and evaluation of long-term course of disease is essential for measuring the outcome quality in the care of cancer patients. This project, based on the ongoing clinical cancer registry of the Comprehensive Oncology Centre (COC) Stuttgart, was aimed to integrate a long-term follow-up documentation and to compare outcome quality between centres of the OCC. ⋯ This project initiated a regular comparative evaluation of the outcome quality and showed that there are statistically significant differences between centres. Based on these findings, the benchmarking process will have to be further developed and elaborated.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Selection of hospital quality indicators for public disclosure in Germany.
This paper introduces the QUALIFY instrument as an indicator assessment method used to select quality indicators suitable for public disclosure in Germany. ⋯ QUALIFY proved to be a useful tool for selecting quality indicators suitable for public disclosure and thus contributes substantially to proper information on German hospital quality. It ensures high transparency in a very sensitive context to all stakeholders.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Benchmarking in psychiatric acute care--a demonstration project in a hospitals network].
The aim of this project was to improve treatment processes and results in acutely ill inpatients within a network of nine psychiatric state hospitals of the Landschaftsverband Rheinland by introducing a benchmarking process. The project was based upon pre-existing measures of quality management. Patient groups were selected that were characterised by a severe clinical development or a high demand for mental health care services (alcohol abuse, depression of the elderly, schizophrenia). ⋯ Although there was no constant quantifiable statistically significant improvement of quality within the three patient groups (and certainly not with respect to the overall network), there was successful improvement of essential treatment processes for certain hospitals and the overall network under benchmarking. This was especially relevant where treatment recommendations were concerned. Future projects should focus on the conformance with treatment guidelines by defining both structural and process measures as a starting point and evaluation criterion.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[QUIPS: quality improvement in postoperative pain management].
Despite the availability of high-quality guidelines and advanced pain management techniques acute postoperative pain management is still far from being satisfactory. The QUIPS (Quality Improvement in Postoperative Pain Management) project aims to improve treatment quality by means of standardised data acquisition, analysis of quality and process indicators, and feedback and benchmarking. During a pilot phase funded by the German Ministry of Health (BMG), a total of 12,389 data sets were collected from six participating hospitals. ⋯ QUIPS demonstrates that patient-reported outcomes in postoperative pain management can be benchmarked in routine clinical practice. Quality improvement initiatives should use outcome instead of structural and process parameters. The concept is transferable to other fields of medicine.