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2017 | OriginalPaper | Hoofdstuk
7. De rol van kwaliteitsindicatoren
Auteurs : Dr. Jozé Braspenning, Dr. Rosella Hermens, Dr. Hilly Calsbeek, Prof. dr. Richard Grol
Gepubliceerd in: Implementatie
Uitgeverij: Bohn Stafleu van Loghum
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Samenvatting
Om de feitelijke zorgverlening ten behoeve van de implementatie van verandering in de zorg goed in kaart te brengen, zijn indicatoren nodig. De precieze invulling van de meting hangt af van het doel van de evaluatie: kwaliteitsverbetering, verantwoording afleggen of wetenschappelijk onderzoek. De noemer van een indicator beschrijft meestal de omvang van de doelgroep waarover een uitspraak wordt gedaan. In de teller wordt het aantal correcte of gewenste handelingen in deze doelgroep beschreven. Indicatoren kunnen de structuur, de processen (klinische en interpersoonlijke handelingen) of de uitkomsten van de zorg betreffen. Er heeft veel discussie plaatsgevonden over de vraag of de evaluatie van de kwaliteit van zorg zich op processen van zorg dan wel op uitkomsten van zorg moet richten. Om tot valide indicatoren te komen, kunnen diverse methoden worden toegepast. Een voorbeeld van een veelgebruikte systematische methode voor selectie van indicatoren is de RAND-procedure. Criteria voor relevantie zijn geschiktheid voor verschillende doelgroepen, impact op de ziekte of de ziektelast, toepasbaarheid op verschillende patiëntengroepen, ruimte voor verbetering van de kwaliteit van zorg en beïnvloedbaarheid van de zorg. Voor het meten van effectiviteit en veiligheid zal men vaak het medische dossier benutten, maar soms bevat dat onvoldoende informatie en is extra registratie nodig. Voor het meten van andere kwaliteitsaspecten zoals toegang, tijdigheid of het in beeld brengen van patiëntervaringen kan soms aansluiting gezocht worden bij bestaande informatiesystemen. Om de voor het meten van de indicatoren verzamelde gegevens goed te kunnen interpreteren en er aanknopingspunten voor de implementatie van nieuwe werkwijzen of verbeteringen in de zorg aan te kunnen ontlenen, worden indicatorscores berekend en eventueel benchmarks gedefinieerd. Voordat de set van indicatoren breed wordt aangeboden, dient een praktijktest te worden uitgevoerd om de validiteit en betrouwbaarheid van de set te toetsen. Na het meten van de indicatoren in de praktijk en voorafgaand aan het formuleren van concrete doelen voor verandering dienen de berekende indicatoren teruggekoppeld te worden aan de zorgverleners in de vorm van feedback. Het doel van feedback is zorgverleners in staat stellen keuzen te maken wat betreft noodzakelijke veranderingen. In diverse landen wordt momenteel met kwaliteitsindicatoren gewerkt om de zorg zichtbaar te maken en zo de kwaliteit te vergroten.
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Metagegevens
- Titel
- De rol van kwaliteitsindicatoren
- Auteurs
-
Dr. Jozé Braspenning
Dr. Rosella Hermens
Dr. Hilly Calsbeek
Prof. dr. Richard Grol
- Copyright
- 2017
- Uitgeverij
- Bohn Stafleu van Loghum
- Boek
-
Implementatie
Print ISBN: 978-90-368-1731-8
Elektronisch ISBN: 978-90-368-1732-5
Copyright: 2017
- DOI
- https://doi.org/10.1007/978-90-368-1732-5_7