Henricus van den Heuvel1. 1. Medical Centre Guetersloh, Nordrhein-Westfalen, Germany. rickvandenheuvel@doctors.org.uk
Abstract
BACKGROUND: The Quality and Outcomes Framework (QOF) has had a major impact on the quality of care in British general practice. It is seen as a major innovation amongst quality indicator systems and as a result various countries are looking at whether such initiatives could be used in their primary care. In Germany also the development of similar schemes has started. AIM: To propose a strategy indicating key issues for the implementation of a quality indicator scheme in German primary care. METHODS: Literature review with a focus on the QOF and German quality indicator literature. RESULTS: There are major differences between the German and British healthcare and primary care systems. The development of quality indicator systems for German general practice is in progress and there is a net force for the implementation of such systems. The following ten key factors are suggested for the successful implementation of such a system in German primary care: involvement of general practitioners (GPs) at all levels of the development, a clear implementation process, investment in practice information technology (IT) systems, an accepted quality indicator set, a quality indicator setting institution and data collection organisation, clear financial and non-financial incentives, a 'practice registration' structure, an exception reporting mechanism, delegation of routine clinical data collection tasks to practice assistants, a stepped implementation approach and adequate evaluation processes. CONCLUSION: For the successful implementation of a quality indicator system in German primary care a number of key issues, as presented in this article, need to be taken into account.
BACKGROUND: The Quality and Outcomes Framework (QOF) has had a major impact on the quality of care in British general practice. It is seen as a major innovation amongst quality indicator systems and as a result various countries are looking at whether such initiatives could be used in their primary care. In Germany also the development of similar schemes has started. AIM: To propose a strategy indicating key issues for the implementation of a quality indicator scheme in German primary care. METHODS: Literature review with a focus on the QOF and German quality indicator literature. RESULTS: There are major differences between the German and British healthcare and primary care systems. The development of quality indicator systems for German general practice is in progress and there is a net force for the implementation of such systems. The following ten key factors are suggested for the successful implementation of such a system in German primary care: involvement of general practitioners (GPs) at all levels of the development, a clear implementation process, investment in practice information technology (IT) systems, an accepted quality indicator set, a quality indicator setting institution and data collection organisation, clear financial and non-financial incentives, a 'practice registration' structure, an exception reporting mechanism, delegation of routine clinical data collection tasks to practice assistants, a stepped implementation approach and adequate evaluation processes. CONCLUSION: For the successful implementation of a quality indicator system in German primary care a number of key issues, as presented in this article, need to be taken into account.