[Methodological Standard for the Development of Quality Indicators within Clinical Practice Guidelines - Results of a structured consensus process].

Methodischer Standard für die Entwicklung von Qualitätsindikatoren im Rahmen von S3-Leitlinien – Ergebnisse einer strukturierten Konsensfindung.
Clinical practice guideline Consensus Evidence-based Evidenzbasiert Konsens Leitlinie Quality assurance Quality indicator Quality of healthcare Qualitätsindikator Versorgungsqualität

Journal

Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen
ISSN: 2212-0289
Titre abrégé: Z Evid Fortbild Qual Gesundhwes
Pays: Netherlands
ID NLM: 101477604

Informations de publication

Date de publication:
Feb 2021
Historique:
received: 27 08 2020
revised: 11 11 2020
accepted: 23 11 2020
pubmed: 24 1 2021
medline: 20 2 2021
entrez: 23 1 2021
Statut: ppublish

Résumé

Recommendations of evidence- and formally consensus-based clinical practice guidelines (CPGs) represent a valuable source of quality indicators (QIs). Nevertheless, a standardized methodological procedure for developing QIs in the context of CPGs does not yet exist in Germany for all CPGs. For this reason, a methodological standard for the guideline-based development of QIs (QI Standard) was developed based on a structured consensus process involving multiple key stakeholders. The proposed content of the QI Standard was derived from evidence, drawing upon results of reviews and qualitative studies, and considered German manuals for guideline-based QI development of two guideline programs. A multi-perspective consensus panel, broadly representing key stakeholders from the German healthcare system with expertise in CPGs and/or quality management, was nominated to vote on recommendations for guideline-based development of QIs. The iterative, structured consensus process included a two-stage online survey based on the Delphi method ("preliminary voting") and a moderated final stakeholder conference where all those recommendations were definitely included in the QI Standard that received approval of more than 75 % (consensus criterion) of the consensus panel. Based on the agreed QI Standard, the QI development process starts with a criteria-based selection of "potential" QIs which - in case of adoption - are published in CPGs as "preliminary" QIs and can achieve the status "final" after successful testing. The QI Standard is composed of a total of 30 recommendations, which are allocated to six areas: A) preparatory work steps for the guideline-based recommendation of QIs, B) QI development group and cooperation with the CPG group, C) development of potential QIs, D) critical appraisal of potential QIs, E) formal adoption and publication as well as F) piloting/testing of preliminary QIs and conversion into final QIs. Before the QI Standard can be recommended for implementation in future CPGs, it should have been successfully tested in selected German CPG projects. In addition to methodological requirements for the QI development, it must be ensured that guideline groups have adequate resources for the implementation of the QI Standard. By using the QI Standard, scientifically sound and healthcare-relevant QIs can be expected.

Sections du résumé

BACKGROUND BACKGROUND
Recommendations of evidence- and formally consensus-based clinical practice guidelines (CPGs) represent a valuable source of quality indicators (QIs). Nevertheless, a standardized methodological procedure for developing QIs in the context of CPGs does not yet exist in Germany for all CPGs. For this reason, a methodological standard for the guideline-based development of QIs (QI Standard) was developed based on a structured consensus process involving multiple key stakeholders.
METHODS METHODS
The proposed content of the QI Standard was derived from evidence, drawing upon results of reviews and qualitative studies, and considered German manuals for guideline-based QI development of two guideline programs. A multi-perspective consensus panel, broadly representing key stakeholders from the German healthcare system with expertise in CPGs and/or quality management, was nominated to vote on recommendations for guideline-based development of QIs. The iterative, structured consensus process included a two-stage online survey based on the Delphi method ("preliminary voting") and a moderated final stakeholder conference where all those recommendations were definitely included in the QI Standard that received approval of more than 75 % (consensus criterion) of the consensus panel.
RESULTS RESULTS
Based on the agreed QI Standard, the QI development process starts with a criteria-based selection of "potential" QIs which - in case of adoption - are published in CPGs as "preliminary" QIs and can achieve the status "final" after successful testing. The QI Standard is composed of a total of 30 recommendations, which are allocated to six areas: A) preparatory work steps for the guideline-based recommendation of QIs, B) QI development group and cooperation with the CPG group, C) development of potential QIs, D) critical appraisal of potential QIs, E) formal adoption and publication as well as F) piloting/testing of preliminary QIs and conversion into final QIs.
DISCUSSION CONCLUSIONS
Before the QI Standard can be recommended for implementation in future CPGs, it should have been successfully tested in selected German CPG projects. In addition to methodological requirements for the QI development, it must be ensured that guideline groups have adequate resources for the implementation of the QI Standard.
CONCLUSION CONCLUSIONS
By using the QI Standard, scientifically sound and healthcare-relevant QIs can be expected.

Identifiants

pubmed: 33483285
pii: S1865-9217(20)30196-3
doi: 10.1016/j.zefq.2020.11.008
pii:
doi:

Types de publication

Journal Article

Langues

ger

Sous-ensembles de citation

IM

Pagination

21-33

Informations de copyright

Copyright © 2021. Published by Elsevier GmbH.

Auteurs

Stefanie Deckert (S)

Zentrum für Evidenzbasierte Gesundheitsversorgung (ZEGV), Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland. Electronic address: stefanie.deckert@uniklinikum-dresden.de.

Katrin Arnold (K)

Zentrum für Evidenzbasierte Gesundheitsversorgung (ZEGV), Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland.

Monika Becker (M)

IFOM - Institut für Forschung in der Operativen Medizin, Department für Humanmedizin Universität Witten/Herdecke, Köln, Deutschland.

Max Geraedts (M)

Institut für Versorgungsforschung und Klinische Epidemiologie, Fachbereich Medizin, Philipps-Universität Marburg, Marburg, Deutschland.

Marie Brombach (M)

Zentrum für Evidenzbasierte Gesundheitsversorgung (ZEGV), Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland.

Jessica Breuing (J)

IFOM - Institut für Forschung in der Operativen Medizin, Department für Humanmedizin Universität Witten/Herdecke, Köln, Deutschland.

Marie Bolster (M)

AWMF-Institut für Medizinisches Wissensmanagement (AWMF-IMWi), c/o Philipps-Universität, Marburg, Deutschland.

Cornelia Assion (C)

Bundesministerium für Gesundheit (BMG), Referat 214 - Qualitätssicherung, Evidenzbasierte Medizin, Berlin, Deutschland.

Norbert Birkner (N)

BQS Institut für Qualität & Patientensicherheit, Hamburg, Deutschland.

Eva Buchholz (E)

Interessenvertretung Selbstbestimmt Leben in Deutschland e.V. (ISL), Berlin, Deutschland; Zentrum für Versorgungsforschung Brandenburg (ZVF-BB), Medizinische Hochschule Brandenburg Theodor Fontane, c/o Immanuel Klinik Rüdersdorf, Rüdersdorf, Deutschland.

Ernst-Günther Carl (EG)

Haus der Krebs-Selbsthilfe - Bundesverband e.V., Bonn, Deutschland.

Franziska Diel (F)

Kassenärztliche Bundesvereinigung (KBV), Dezernat Versorgungsqualität, Berlin, Deutschland.

Klaus Döbler (K)

Kompetenzzentrum Qualitätssicherung / Qualitätsmanagement (KCQ), MDK Baden-Württemberg, Stuttgart, Deutschland.

Markus Follmann (M)

Deutsche Krebsgesellschaft e.V., Leitlinienprogramm Onkologie, Berlin, Deutschland.

Timo Harfst (T)

Bundespsychotherapeutenkammer, Berlin, Deutschland.

Monika Klinkhammer-Schalke (M)

Arbeitsgemeinschaft Deutscher Tumorzentren e.V., Berlin, Deutschland.

Ina Kopp (I)

AWMF-Institut für Medizinisches Wissensmanagement (AWMF-IMWi), c/o Philipps-Universität, Marburg, Deutschland.

Burkhard Lebert (B)

Frauenselbsthilfe Krebs - Bundesverband e.V., Bonn, Deutschland.

Dagmar Lühmann (D)

Institut und Poliklinik für Allgemeinmedizin, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.

Claudia Meiling (C)

Deutscher Verband der Ergotherapeuten e.V., Referat Standards und Qualität, Karlsbad, Deutschland.

Tim Niehues (T)

Helios Klinikum Krefeld, Zentrum für Kinder- und Jugendmedizin, Krefeld, Deutschland.

Thomas Petzold (T)

Gesellschaft für Qualitätsmanagement in der Gesundheitsversorgung e.V. (GQMG), Köln, Deutschland.

Susanne Schorr (S)

Ärztliches Zentrum für Qualität in der Medizin (ÄZQ), Berlin, Deutschland.

Reina Tholen (R)

Deutscher Verband für Physiotherapie (ZVK) e.V., Köln, Deutschland.

Simone Wesselmann (S)

Deutsche Krebsgesellschaft e.V., Zertifizierung, Berlin, Deutschland.

Karen Voigt (K)

Bereich Allgemeinmedizin/MK3, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland; Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM), Berlin, Deutschland.

Gerald Willms (G)

aQua - Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen, Göttingen, Deutschland.

Edmund Neugebauer (E)

IFOM - Institut für Forschung in der Operativen Medizin, Department für Humanmedizin Universität Witten/Herdecke, Köln, Deutschland; Medizinische Hochschule Brandenburg - Theodor Fontane, Neuruppin, Deutschland.

Dawid Pieper (D)

IFOM - Institut für Forschung in der Operativen Medizin, Department für Humanmedizin Universität Witten/Herdecke, Köln, Deutschland.

Monika Nothacker (M)

AWMF-Institut für Medizinisches Wissensmanagement (AWMF-IMWi), c/o Philipps-Universität, Marburg, Deutschland.

Jochen Schmitt (J)

Zentrum für Evidenzbasierte Gesundheitsversorgung (ZEGV), Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland.

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Classifications MeSH