Development of dashboards for Quality and Safety Management

Which challenges do hospitals face in the development process of hospital-wide Quality and Safety dashboards and how do they overcome them? Is it possible to learn from others and speed up the development process

Ontwikkeling is een uitdaging; Dashboards voor Kwaliteit en Veiligheid in ziekenhuizen

Externe partijen vragen in toenemende mate om inzicht en transparantie over de kwaliteit van zorg voor het uitvoeren van hun controlerende taak. Zorgprofessionals hebben behoefte aan cijfers over de geleverde zorg- en dienstverlening, zodat zij kunnen verbeteren. Wetenschappelijke verenigingen stimuleren het opzetten van ziektebeeld gebonden registraties. Al deze verzamelde informatie kunnen instellingen ook gebruiken voor interne sturing op basis van een kwaliteitsdashboard

Resource use and costs of type 2 diabetes patients receiving managed or protocolized primary care:A controlled clinical trial

Background: The increasing prevalence of diabetes is associated with increased health care use and costs. Innovations to improve the quality of care, manage the increasing demand for health care and control the growth of health care costs are needed. The aim of this study is to evaluate the care process and costs of managed, protocolized and usual care for type 2 diabetes patients from a societal perspective. Methods. In two distinct regions of the Netherlands, both managed and protocolized diabetes care were implemented. Managed care was characterized by centralized organization, coordination, responsibility and centralized annual assessment. Protocolized care had a partly centralized organizational structure. Usual care was characterized by a decentralized organizational structure. Using a quasi-experimental control group pretest-posttest design, the care process (guideline adherence) and costs were compared between managed (n = 253), protocolized (n = 197), and usual care (n = 333). We made a distinction between direct health care costs, direct non-health care costs and indirect costs. Multivariate regression models were used to estimate differences in costs adjusted for confounding factors. Because of the skewed distribution of the costs, bootstrapping methods (5000 replications) with a bias-corrected and accelerated approach were used to estimate 95% confidence intervals (CI) around the differences in costs. Results: Compared to usual and protocolized care, in managed care more patients were treated according to diabetes guidelines. Secondary health care use was higher in patients under usual care compared to managed and protocolized care. Compared to usual care, direct costs were significantly lower in managed care (-1.181 (95% CI: -2.597 to -334)) while indirect costs were higher (758 (95% CI: -353 to 2.701), although not significant. Direct, indirect and total costs were lower in protocolized care compared to usual care (though not significantly). Conclusions: Compared to usual care, managed care was significantly associated with better process in terms of diabetes care, fewer secondary care consultations and lower health care costs. The same trends were seen for protocolized care, however they were not statistically significant. Trial registration. Current Controlled trials: ISRCTN66124817. © 2014 van der Heijden et al.; licensee BioMed Central Ltd

HANDLEIDING VORMGEVING van DASHBOARDS met kwaliteitsinformatie

De doelstelling van het onderzoek luidde: het onderzoeken van een effectieve actiegerichte presentatie van ziekenhuisbrede kwaliteitsindicatoren op een executive dashboard voor de Raad van Bestuur (en haar ondersteuners), ten behoeve van signaleren, controleren, verantwoorden, dialoog voeren, verbeteren of benchmark vergelijking tussen ziekenhuizen. Het onderzoek bouwde voort op eerder uitgevoerd onderzoek in het programma Sturen op Kwaliteit en de daarin ontwikkelde indicatoren uit de deelprojecten