Annual Research Meeting 2006 Seattle
Dr. Christof Veit, Hamburg
The Structured Dialog
National Quality Benchmarking in Germany
Quality Benchmarking and Dialog
Benchmarking: The Principle.
Define good quality in health care,
measure and
improve it
in all hospitals involved nationwide.
Quality Benchmarking and Dialog
Benchmarking: The Principle.
The enthusiastic ones: Involve.
The neutral ones: Inform. Attract.
The critical ones: Use their critique.
The refusing ones: Make it unattractive.
Quality Benchmarking and Dialog
Benchmarking: Size of the project.
> 2,000 German Hospitals (> 98%)
> 5,000 medical departments
> 3 Mio cases in 2005
> 20% of all hospital cases in Germany
> 300,000 Cases in Hamburg in 2005
> 300 Quality indicators in 26 areas of care
> 800 experts involved (national and regional)
Quality Benchmarking and Dialog
Benchmarking: The Idea.

define standards (evidence based, public)
 define

levels of acceptance
document processes, risks and results
present variation
 start structured dialog

 improve
and check
Quality Benchmarking and Dialog
Benchmarking: The Participants.
Federal Joint
Committee
G-BA
National
Institut
BQS
National
Expert
Groups
Structured dialog
National
Data Base
Hospitals
(central projects)
data
transfer
national
State Steering
Committee
State
Project Office
State
Expert
Groups
Structured dialog
State
Data Base
Hospitals
regional
Quality Benchmarking and Dialog
Project
Office
Experts
Quality Benchmarking and Dialog
Project
Office
Experts
numerical outliers
Quality Benchmarking and Dialog
Steering Committee
Structured
Report
National Committee
and National Experts
Project
Office
Experts
Correct!
Check!
qualitative outliers
Quality Benchmarking and Dialog
Variation!
Best practice!
Improve! Check!
Project
Office
Experts
regional meetings
Quality Benchmarking and Dialog
Benchmarking: Projects.
26 Projects on the National Level e.g.
Hip- and Knee Replacement
Cholecystectomy
Gynaecological Operations
Breast Cancer Operations
Obstetrics
Cardiac Pace Makers
Coronary Catheters
Heart Surgery
Decubital Ulcers
Pneumonia
.........and others
Quality Benchmarking and Dialog
Benchmarking: Questions.
data validity
risk adjustment
confidentiality
public quality report
improvement instead of league tables
Quality Benchmarking and Dialog
Benchmarking: Results.
Due to upcoming publication only a small part of
results can be shown here. Yet on personal
request more data can be made available.
Thanks for your understanding.
c.veit@EQS.de
Quality Benchmarking and Dialog
Quality Benchmarking and Dialog
Benchmarking: Results.
Antibiotic Prophylaxes and Wound infection
in Hip-Replacement 2001 – 2004
Hamburg Hospitals, 3.500 cases per year
100%
95%
90%
85%
80%
75%
70%
65%
60%
55%
50%
2001
2002
2003
2004
Quality Benchmarking and Dialog
Improvement.
Hamburg: Antibiotic Prophylaxes in Hip-Replacement.
2003: 95,6%
%
2004: 98,5%
100
100
90
90
80
80
70
70
60
60
50
50
40
40
30
30
20
20
10
10
0
0
Hospitals
Quality Benchmarking and Dialog
Benchmarking: Future.
longterm outcome
interactive internet with trend analysis
problem focus
participant cooperation
public information
Quality Benchmarking and Dialog
Features for success.
 commitment of the big players in health care
 fixed framework, flexible machinery, efficient decisions
 involvement of existing institutions
 methodology, transparency and fairness
 commitment to improvement
 resist secondary interests
Quality Benchmarking and Dialog
Thanks for your attention.
c.veit@EQS.de
Quality Benchmarking and Dialog