Post on 17-Jan-2018
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EVALUATING SWEDISHQUALITY REGISTERS
BERTIL LINDAHLwww.kvalitetsregister.se
Definition of a National Quality Register (NQR)
• A national quality register contains individualized data concerning patient problems, medical interventions, and outcomes after treatment; within all healthcare production.
• It is annually monitored and approved for financial support by an Executive Committee.
Quality registers
Decision committee
Steering committee
Expertgroup
QR -office
Reference groups
National register service
SoS
Register Centra (RC)
Regional Cancer Centra (RCC)
Vision for NQRs
NQRs are used in an integrated and active way for:
• continuous learning and improvement
• research
• management
to create the best possible health and care together
with the individual.
Evaluating quality of NQRs
• Structure
• Process
• Outcome
The Donabedian model
• Structure– NQR steering committee and chairman
(registerhållare)• good support in health care with good geographical
spread• multiprofessional• patient representatives• CPUA – the legally responsible from the county council
– Access to necessary competences– Appropriate IT-system in place– Well defined quality indicators– System for continuous validation and monitoring
• Process– Data are continuously reported to the registry– Data are validated and the completeness
(täckningsgrad) evaluated– Data are regularly / continuously analyzed and
reported back to • Reporting units• Other stake holders• Used in “open comparisons” (öppna jämförelser)
– Data are delivered and used for:• Local quality improvement• Bench marking• Research
– Results are publically reported on hospital level
• Outcome – Successful improvement of care• Better medical results• Improved patient involvement and patient satisfaction• More equitable care• Lower costs
– Used for management of care at different levels– Successful research• Publication in international journals• Industry collaboration• Innovations
Certification (2014)
• NQR candidate – 24 registers
• NQR level 3 – 52 registers
• NQR level 2 – 22 registers
• NQR level 1 – 7 registers
CURRENT STATUS REPORT SPRING 2014 - for the national investment in NQRs
Report on how the NQRs meet the goals in the different areas
0
50
100
150
200
250
300
350
400
år 2009 år 2010 år 2011 år 2012 år 2013
+ 183 %
Number of articles published in scientific journals
0
5
10
15
20
25
30
35
40
1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 55 58 61 64 67
Number of articles/register
External evaluations- the Swedish Agency for Health and Care Services Analysis
Completeness in relation to year of start of the register
Conclusions
• Evaluating the Swedish NQRs is a complex task– Several different types of registers– Several aspects of quality to consider– Various degree of maturity– Various difficult to evaluate the structure, process and
outcome• There has been a substantial positive development of
the quality of the NQRs• Large differences between different NQRs• There are remaining challenges in several areas
Thank you for the attention!