>> The German healthcare system is currently undergoing a serious system change, whereby quality, not just quantity, will play a central role in inpatient and cross-sector quality assurance in the future. In order to support this request politically, from January 2016 the successor institution to the AQUA Institute will be
tituts, the Institute for Quality Assurance and Transparency in Health Care (IQTiG) begins its work, whose head is Dr. Christoph Veit (formerly BQS). As chairman of the plenary session, he took into account the suggestions made by the speakers in the lectures - from Prof. Dr. Joachim Szecsenyi about Prof. Dr. Max Geraedts, up to Dr. Regina Klakow-Franck and Prof. Dr. Matthias Schrappe – quite open. No wonder: How quality of care can be measured and presented, what requirements must be placed on legal QA from a scientific perspective and how patient surveys can be integrated, all of this was the subject of this meeting, which, however, resulted in a small scientific controversy between Szecsenyi (AQUA) and Geraedts (Witten-Herdecke) culminated.
“Achieve a certain quality standard”
“Four method papers were created within just under six years,” explained Szecsenyi. In these years, not only the development of quality assurance procedures can be seen, but also potential for improvement has been identified and the way in which experts who can be involved in the development of quality indicators can even be explained. Everything can be read on the portal www.SQG.de, which will probably continue to be operated by AQUA's successor institute, IQTiG, as he assured himself with a sideways glance at plenary chairman Veit.
The quality reports that were also created contain information about the status of the legally required external inpatient quality assurance procedures.
new methods of presentation have been created to improve the comprehensibility of the information contained therein, and in some cases even to make it understandable to laypeople.
In 2014, 1,557 hospitals brought in around 3.25 million patient cases from 30 service areas. According to Szecsenyi, surgical procedures are strongly represented here, but this has to do with the history of external inpatient quality assurance in Germany. A total of 416 quality indicators are shown, with a 15.6 percent improvement rate compared to the previous year. There is always a certain amount of fluctuation, but in 79 percent the quality of care has remained the same. Szecsenyi: “But that is also a concern of statutory quality assurance, to ensure that we achieve a certain quality standard and that there is therefore reliable supply.” That’s why it wouldn’t do any harm if the indicators remained the same, they said would be within the specified reference ranges.
“Between 99 and 100 percent are consistently excellent”
Geraedts, who took the perspective of health services research on statutory quality assurance within the plenary session, saw things somewhat differently. First of all, he questioned whether the external quality assurance had resulted in any improvement in the quality of care. In order to achieve this goal, knowledge of the quality reports on the part of the doctors, but also on the part of the patients, is first and foremost necessary in order to enable an informed choice of hospital or advice. But that's not entirely the case. In a study funded by the G-BA, in which a group of patients who had undergone procedures from five different QS service areas was included, they were presented with excerpts from quality reports while they were still in the hospital, which shed light on the specialist departments visited. Afterwards, the patients were asked what they could do with this information. First finding: Patients do not know the quality reports in advance. The second: Only an absolute minority understands the quality reports after reading them and therefore only considers their contents to be helpful to a limited extent.
A similar study approach was carried out with a large sample of hospital patients. The result here too: Of around 2,000 representative patients, only 9 percent of those patients who are actually in hospital actually use the Internet for information before being admitted to hospital. This is, for example, in obstetrics, pediatrics and... <<