quality control of gynecological operations in sweden: how and what? gynop swedish national quality...

Quality control 

of gynecological operations 

in Sweden: 

How and what? 

GYNOPSwedish National Quality Register of Gynecological Surgery

www.gynop.org

Emil Nüssler

HOW?Measurements for Improved Quality in Healthcare

SingaporeChinaIndiaScotlandEnglandAustraliaCanada

+Denmark+Germany+ ….

TOP – DOWN

Government + departments...

Quality indicators

RecommandationsStandards

CertificationAccreditation

National statistics

Emil Nüssler

Sweden

+ Australia?

BOTTOM – UP….

Enthusiasts + nerds...

HOW?Measurements for Improved Quality in Healthcare

Emil Nüssler

Sweden BOTTOM – UP….

Enthusiasts + nerds...

Rapidly growing number registries in the nineties

1997 Gynop

2007 ”the local authorities and regions took the responsibility of the continuing operation, development, and financing of the registries”

HOW?Measurements for Improved Quality in Healthcare

Emil Nüssler

Sweden BOTTOM – UP….

Sweden today...

8 ”competence centres”

78 ”accepted” national quality registries

24 ” candidate” registries

HOW?Measurements for Improved Quality in Healthcare

Emil Nüssler

Database

LaparoscopyHystero-scopy

HOW? The gynaecological family 1997

Emil Nüssler

Database

Benign abd. surgery

Adnex

Hystero-scopy

Malignanttumours

Prolapse

Incon-tinence

HOW? The gynecological family since 2006

Emil Nüssler

Pre-op questionnaire

Questionnaire1 year post-op

Questionnaire 8 weeks post-OP

PATIENT DOCTOR

Emil Nüssler

Pre-OP questionnaire

Questionnaire1 year post-OP

Questionnaire 8 weeks post-OP

Status at ADMISSION

OPERATION

Status at DISCHARGE

PATIENT DOCTOR

8 weeks - assessment

1 year - assessment

Emil Nüssler

CARE orientedMedical perfection

PATIENT orientedFitness for purpose

MANAGEMENT orientedValue for money

WHAT? QUALITY?????

Emil Nüssler

on NATIONAL LEVEL ?

What do we do with our data? COMPARISON

Emil Nüssler

Uninformative for the clinician

on NATIONAL LEVEL =

What do we do with our data? COMPARISON

Emil Nüssler

Uninformative for the clinician

Irrelevant for the patient

on NATIONAL LEVEL =

What do we do with our data? COMPARISON

Emil Nüssler

Uninformative for the clinician

Irrelevant for the patient

Boring, for quality-minded professionals

on NATIONAL LEVEL =

What do we do with our data? COMPARISON

Emil Nüssler

COMPARISON

on CLINIC + INDIVIDUAL LEVEL ?

Emil Nüssler

COMPARISON

”IMPOSSIBLE”on CLINICAL + INDIVIDUAL LEVEL =

Emil Nüssler

COMPARISON

”IMPOSSIBLE”

because of ….

CASE MIX………

POLITICS………

MONEY…………

EGO…………….

TRADITIONS…..

..anything goes..

on CLINIC + INDIVIDUAL LEVEL =

Emil Nüssler

COMPARISON

YES WE CAN…

Comparable Patient Groups

Dynamic Benchmark

on CLINICAL + INDIVIDUAL LEVEL =

Emil Nüssler

COMPARISON on NATIONAL LEVEL

Emil Nüssler

COMPARISON on CLINICAL LEVEL version 2006

Einfache Prolapsoperationen

Emil Nüssler

Einfache Prolapsoperationen

Dynamic Benchmark

COMPARISON on CLINICAL LEVEL version 2009

Emil Nüssler

Einfache Prolapsoperationen

COMPARISON on CLINICAL LEVEL version 2012

Emil Nüssler

What do we do with our data?

Production reports

Special reports

”Open report”(Öppna Jämförelser)

Gyn. Departments ”annual report”

Scientific research ”for all”

Pre-op informationof patients

Clinical data + ”Rapportgenerator”

Quality control 

ain’t easy…..

Thank youfor listening!  

emil.nussler@gmail.comSwedish National Quality Register of Gynecological Surgery

www.gynop.org