Anke Bramesfeld1, Michel Wensing2, Paul Bartels3, Henning Bobzin4, Catherine Grenier5, Mona Heugren6, Dena Jaffe Hirschfield7, Manfred Langenegger8, Birgitta Lindelius6, Bruno Lucet5, Orly Manor5, Theres Schneider8, Fiona Wardell9, Joachim Szecsenyi10. 1. AQUA-Institute for Applied Quality Improvement and Research in Health Care, Maschmühlenweg 8, 37073 Göttingen, Germany; Institute for Epidemiology, Social Medicine and Health System Research, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany. Electronic address: bramesfeld.anke@mh-hannover.de. 2. Radboud University Medical Centre, Radboud Institute of Health Sciences, Geert Grooteplein 21, 6500 HB Nijmegen, The Netherlands. 3. The Danish Clinical Registries-A National Quality Improvement Programme, Olof Palmes Allé 15, 8200 Aarhus, Denmark. 4. AQUA-Institute for Applied Quality Improvement and Research in Health Care, Maschmühlenweg 8, 37073 Göttingen, Germany. 5. Direction de l'Amélioration de la Qualité & de la Sécurité des Soins, Haute Autorité de Santé, 2, Avenue du Stade de France, 93218 Saint Denis La Plaine Cedex, France. 6. National Board of Health and Welfare, Rålambsvägen 3, SE 10630 Stockholm, Sweden. 7. Braun School of Public Health & Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel; Kantar Health, Health Outcomes Practice, Jerusalem, Israel. 8. Bundesamt für Gesundheit BAG, Direktionsbereich Kranken- und Unfallversicherung, Schwarzenburgerstr. 175, 3003 Bern, Switzerland. 9. Healthcare Improvement Scotland, Delta House, 50 West Nile Street, Glasgow G1 2NP, United Kingdom. 10. Healthcare Improvement Scotland, Delta House, 50 West Nile Street, Glasgow G1 2NP, United Kingdom; Department of General Practice and Health Services Research, Heidelberg University Hospital, Voßstr. 2, D-69115 Heidelberg, Germany.
Abstract
INTRODUCTION: Quality improvement systems (QIS) that are based on empirical performance assessment have increasingly been implemented as a mandatory part of health systems across countries. This study aims to describe national mandatory QIS in Europe in 2014. MATERIALS AND METHODS: Relevant national agencies for national mandatory QIS in Europe were identified through online searches and key informants. A questionnaire was compiled during a workshop with these agencies and filled out by representatives from these particular agencies. RESULTS: Agencies in charge of national mandatory QIS in seven countries (Denmark, France, Germany, Israel, Scotland, Sweden and Switzerland) were included in the study. An analysis of QIS revealed similarities, such as the use of routine data for performance assessment and the aim to hold healthcare providers accountable. Differences relate to the different forms of feedback systems and improvement mechanisms used. Trends include the development towards greater implementation of QIS within health systems, the inclusion of the patient's perspective in performance assessment, and experiments with pay for performance-related measures. CONCLUSION: On a country level, for health systems striving for newly implementing QIS it is recommended to start where routine data is available, add qualitative methodologies once the QIS is getting more complex, report performance data back to service providers and be patient centred. On the inter-country level exchange of information between agencies commissioned with implementing national QIS is very much needed for. Crown Copyright Â
INTRODUCTION: Quality improvement systems (QIS) that are based on empirical performance assessment have increasingly been implemented as a mandatory part of health systems across countries. This study aims to describe national mandatory QIS in Europe in 2014. MATERIALS AND METHODS: Relevant national agencies for national mandatory QIS in Europe were identified through online searches and key informants. A questionnaire was compiled during a workshop with these agencies and filled out by representatives from these particular agencies. RESULTS: Agencies in charge of national mandatory QIS in seven countries (Denmark, France, Germany, Israel, Scotland, Sweden and Switzerland) were included in the study. An analysis of QIS revealed similarities, such as the use of routine data for performance assessment and the aim to hold healthcare providers accountable. Differences relate to the different forms of feedback systems and improvement mechanisms used. Trends include the development towards greater implementation of QIS within health systems, the inclusion of the patient's perspective in performance assessment, and experiments with pay for performance-related measures. CONCLUSION: On a country level, for health systems striving for newly implementing QIS it is recommended to start where routine data is available, add qualitative methodologies once the QIS is getting more complex, report performance data back to service providers and be patient centred. On the inter-country level exchange of information between agencies commissioned with implementing national QIS is very much needed for. Crown Copyright Â