Implementation of anesthesia quality indicators in Germany
Der Anaesthesist, vol. 70, pp. 38–47
Abstract
BACKGROUND: In 2016 the German Society of Anesthesiology and Intensive Care Medicine (DGAI) and the Association of German Anesthetists (BDA) published 10 quality indicators (QI) to compare and improve the quality of anesthesia care in Germany. So far, there is no evidence for the feasibility of implementation of these QI in hospitals. OBJECTIVE: This study tested the hypothesis that the implementation of the 10 QI is feasible in German hospitals. MATERIAL AND METHODS: This prospective three-phase national multicenter quality improvement study was conducted in 15 German hospitals and 1 outpatient anesthesia center from March 2017 to February 2018. The trial consisted of an initial evaluation of pre-existing structures and processes by the heads of the participating anesthesia departments, followed by a 6-month implementation phase of the QI as well as a final re-evaluation phase. The implementation procedure was supported by web-based implementation aids ( www.qi-an.org ) and internal quality management programs. The primary endpoint was the difference in the number of implemented QI per center before and after implementation. Secondary endpoints were the number of newly implemented QI per center, the overall number of successful implementations of each QI, the identification of problems during the implementation as well as the kind of impediments preventing the QI implementation. RESULTS: The average number of implemented QI increased from 5.8 to 6.8 (mean of the differences 1.1 ± 1.3; P < 0.01). Most frequently the QI perioperative morbidity and mortality report (5 centers) and the QI temperature management (4 centers) could be implemented. After the implementation phase, the QI incidence management and patient blood management were implemented in all 16 centers. Implementation of other quality indicators failed mainly due to a lack of time and lack of structural resources. CONCLUSION: In this study the implementation of QI was proven to be mostly feasible in the participating German hospitals. Although several QI could be implemented with minor effort, more time, financial and structural resources would be required for some QI, such as the QI postoperative visit.
Authors 21
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Affiliation as printed
Department of Anaesthesiology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
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Affiliation as printed
Department of Anaesthesiology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany. mcoburn@ukaachen.de
Department of Anaesthesiology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
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Affiliation as printed
Department of Anaesthesiology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
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Affiliation as printed
Department of Anaesthesiology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
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University of Freiburg · University Medical Center Freiburg
Affiliation as printed
Department of Anaesthesiology and Critical Care Medicine, Faculty of Medicine, University Hospital Freiburg, Freiburg, Germany
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St. Vincenz-Krankenhaus Limburg
Affiliation as printed
Department of Anaesthesiology, St. Vincenz Hospital Limburg, Limburg, Germany
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Affiliation as printed
Department of Anaesthesiology and Critical Care Medicine, St.-Vincentius Hospital Karlsruhe, Karlsruhe, Germany
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Herford Hospital · Ruhr University Bochum
Affiliation as printed
Department of Anaesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Klinikum Herford, Ruhr-University Bochum, Herford, Germany
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Affiliation as printed
Department of Anaesthesiology, Critical Care and Pain Medicine, Klinikum Mittelbaden, Baden-Baden, Germany
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Affiliation as printed
Outpatient Anaesthesia Care Centre Karst, Berlin, Germany
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Klinikum Mutterhaus der Borromäerinnen
Affiliation as printed
Department of Anaesthesiology and Critical Care Medicine, Klinikum Mutterhaus der Borromäerinnen, Trier, Germany
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Affiliation as printed
Department of Anaesthesiology, Critical Care, Emergency and Pain Medicine, St. Barbara Hospital, Hamm, Germany
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Affiliation as printed
Department of Anaesthesiology and Critical Care Medicine, University Hospital Jena, Jena, Germany
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Affiliation as printed
Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Würzburg, Würzburg, Germany
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Affiliation as printed
Department of Anaesthesiology and Critical Care Medicine, Hospital St. Elisabeth, Damme, Germany
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Universitätsmedizin Rostock · University of Rostock
Affiliation as printed
Department of Anaesthesiology and Critical Care Medicine, University Hospital Rostock, Rostock, Germany
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Affiliation as printed
Department of Anaesthesiology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
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Affiliation as printed
Department of Anaesthesiology and Surgical Intensive Care Medicine, Klinikum Stuttgart, Stuttgart, Germany
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Affiliation as printed
Department of Anaesthesiology and Critical Care Medicine, University Hospital Bonn, Bonn, Germany
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Affiliation as printed
Department of Anaesthesiology and Pain Medicine, Klinikum Bremen-Mitte, Bremen, Germany
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Affiliation as printed
Department of Anaesthesiology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
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