A web-based system to facilitate local, systematic quality improvement by multidisciplinary care teams: development and first experiences of CARDSS Online.

Continuous monitoring and systematic improvement of quality have become increasingly common in healthcare. To support multidisciplinary care teams in improving their clinical performance using feedback on quality indicators, we developed the CARDSS Online system. This system supports (i) monitoring of indicator-based performance, (ii) selecting aspects of care that need improvement, (iii) developing a quality improvement (QI) plan, and (iv) periodically adjusting the QI plan. During educational outreach visits, the system actively involves the team in the improvement effort, and guides them through the process of systematic QI without needing extensive knowledge of the underlying concepts. During the implementation of the system in the field of cardiac rehabilitation (CR) in the Netherlands, we have conducted the first outreach visits to four CR teams. During the visits, the teams formulated QI plans consisting of 4 to 7 improvement goals, each goal accompanied by 1 to 5 QI actions. Currently, we are evaluating the effect of CARDSS Online on the quality of CR in the Netherlands in a cluster randomized trial.