• Kwaliteitsindicatoren voor de heelkunde. Ontwikkeling en toepassing van een set indicatoren

      Kooistra M; Graafmans WC; Go PMNYH; Vries AC de; Vree R; Westert GP; PZO (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2007-11-29)
      In the media and in scientific publications there is a growing interest in the quality of health care and possible differences in quality among hospitals and doctors. Quality of care is important for patients who receive care and for doctors who deliver care. Central in this discussion is the question how we should measure quality of care. Indicators may be helpful in measuring quality of care. In this study we developed and tested a set of quality-indicators for surgical care. The Dutch Health Care Inspectorate requested the National Institute for Public Health and the Environment (RIVM)to develop this set of indicators to support their inspection activities. This study was carried out in close collaboration with the Dutch Society for Surgeons (NVvH). To define a limited set of indicators for surgical care, three steps were taken. In the first step a working group, with members of the NVvH and researchers of RIVM, identified risks of suboptimal care. In the second step, indicators were identified to measure suboptimal care, based on the literature and expert opinion. In the third step, after a consensus procedure, a set of 9 indicators was selected: percentage reoperations within 30 days (planned or unplanned), percentage in-hospital mortality, percentage postoperative wound infections, percentage biliary duct injury, length of stay appendectomy, postoperative length of stay after colon resections, time between admission and hip fracture surgery, percentage exploratory thoracotomy and percentage pneumectomy versus pulmonary lobectomy. To evaluate the feasibility of the registration of these indicators, we tested the registration in several hospitals. Further development of a system for data registration and processing is necessary for successful implementation of the indicators. As a result of this study, the NVvH selected some indicators in agreement with the Inspectorate of Health Care to be included in the set 'performance indicators for hospitals'.