quality control of gynecological operations in sweden: how and what? gynop swedish national quality...
TRANSCRIPT
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
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Database
LaparoscopyHystero-scopy
HOW? The gynaecological family 1997
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Database
Benign abd. surgery
Adnex
Hystero-scopy
Malignanttumours
Prolapse
Incon-tinence
HOW? The gynecological family since 2006
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Pre-op questionnaire
Questionnaire1 year post-op
Questionnaire 8 weeks post-OP
PATIENT DOCTOR
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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
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CARE orientedMedical perfection
PATIENT orientedFitness for purpose
MANAGEMENT orientedValue for money
WHAT? QUALITY?????
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on NATIONAL LEVEL ?
What do we do with our data? COMPARISON
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Uninformative for the clinician
on NATIONAL LEVEL =
What do we do with our data? COMPARISON
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Uninformative for the clinician
Irrelevant for the patient
on NATIONAL LEVEL =
What do we do with our data? COMPARISON
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Uninformative for the clinician
Irrelevant for the patient
Boring, for quality-minded professionals
on NATIONAL LEVEL =
What do we do with our data? COMPARISON
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COMPARISON
on CLINIC + INDIVIDUAL LEVEL ?
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COMPARISON
”IMPOSSIBLE”on CLINICAL + INDIVIDUAL LEVEL =
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COMPARISON
”IMPOSSIBLE”
because of ….
CASE MIX………
POLITICS………
MONEY…………
EGO…………….
TRADITIONS…..
..anything goes..
on CLINIC + INDIVIDUAL LEVEL =
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COMPARISON
YES WE CAN…
Comparable Patient Groups
Dynamic Benchmark
on CLINICAL + INDIVIDUAL LEVEL =
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COMPARISON on NATIONAL LEVEL
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COMPARISON on CLINICAL LEVEL version 2006
Einfache Prolapsoperationen
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Einfache Prolapsoperationen
Dynamic Benchmark
COMPARISON on CLINICAL LEVEL version 2009
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Einfache Prolapsoperationen
COMPARISON on CLINICAL LEVEL version 2012
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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!
[email protected] National Quality Register of Gynecological Surgery
www.gynop.org