Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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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.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Developing quality indicators: background, methods and problems].
Quality indicators (QIs) are used in many areas of health care in order to measure, compare, and improve quality. QIs are specific, measurable aspects of care that can be used to assess its quality. Assessing the quality of care contributes to quality improvement. ⋯ QIs can be developed on the basis of expert opinion, scientific evidence or clinical practice guidelines. For the efficient development of high quality QIs, rigorous, approved, and evidence-based development methods are needed. At present, there is no gold standard for the development of QIs.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Balancing benefit and harm in palliative care: the difficult position of palliative medicine in view of the promises of curative medicine].
The significance of palliative care as an interdisciplinary and multi-professional approach to treating patients with extremely severe medical conditions should be investigated using the same methodological standards as for clinical medicine in general. Clinical studies in palliative medicine show that certain standards, e.g. in pain therapy, have still not been sufficiently implemented. There is also a lack of methodologically appropriate studies to investigate palliative medicine as a complex intervention. This research deficit is all the more regrettable as - specifically in the field of oncology - it can be demonstrated that the benefit provided by the services of palliative care teams is very large, especially for patients with a particularly unfavorable course of the disease.