Article
Updating Guideline based Quality Indicators. The Methodology of the German Breast Cancer Guideline Development Group
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Published: | July 10, 2012 |
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Outline
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Background: According to the goals of the National Cancer Plan, the German Guideline Program in Oncology (GGPO) funds and supports the development, implementation, evaluation and update of evidence-based guidelines to improve cancer care. The development and update of guideline based Quality indicators (QI) is a key element of the GGPO methodology.
Context: 2011, the German Breast Cancer Guideline Development Group updated the 2008 version of their guideline. In this context, QI derived from the previous guideline version were reassessed.
Description of best practice: A 5 step strategy to update QI will be described and explained by examples:
- Critical review of the necessity of QI in terms of a remaining potential for quality improvement based on data from cancer registries, audits of cancer centers and quality assurance according to the German social code book.
- Critical appraisal of new evidence in terms of need for changes in guideline recommendations and aligned QI.
- Assessment of the relevance, scientific soundness and feasibility of QI in a criteria-based Delphi-process with involvement of relevant stakeholders.
- Allocation of QI to the different models and structures for quality improvement existing in Germany.
- Reaching consensus on inclusion of QI.
Lessons for guideline developers, adaptors, implementers, and/or users: QI are important tools to assess the quality of care and the impact of guidelines. Like guideline recommendations, QI have to be updated regularly. QI performance and structures for implementation need to be considered. A standardized process involving all relevant stakeholders is recommended to achieve data economy.