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Quality control  of gynecological operations in Sweden:  How and what? 

Quality control  of gynecological operations in Sweden:  How and what? . GYNOP Swedish National Quality Register of Gynecological Surgery www.gynop.org. HOW? Measurements for Improved Quality in Healthcare. TOP – DOWN. Singapore China India Scotland England Australia Canada

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Quality control  of gynecological operations in Sweden:  How and what? 

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  1. Quality control  of gynecological operations in Sweden:  How and what?  GYNOP Swedish National Quality Register of Gynecological Surgery www.gynop.org

  2. HOW?Measurements for Improved Quality in Healthcare TOP – DOWN Singapore China India Scotland England Australia Canada +Denmark +Germany + …. • Government + departments... • Quality indicators • Recommandations • Standards • Certification • Accreditation • National statistics

  3. HOW?Measurements for Improved Quality in Healthcare BOTTOM – UP…. Sweden + Australia? • Enthusiasts + nerds...

  4. HOW?Measurements for Improved Quality in Healthcare BOTTOM – UP…. Sweden • 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”

  5. HOW?Measurements for Improved Quality in Healthcare BOTTOM – UP…. Sweden • Sweden today... • 8 ”competence centres” • 78 ”accepted” national quality registries • 24 ” candidate” registries

  6. HOW? The gynaecological family 1997 Laparoscopy Hystero- scopy Database

  7. HOW? The gynecological family since 2006 Adnex Benign abd. surgery Hystero- scopy Database Malignant tumours Prolapse Incon-tinence

  8. DOCTOR PATIENT Pre-op questionnaire Questionnaire 8 weeks post-OP Questionnaire 1 year post-op

  9. DOCTOR PATIENT Pre-OP questionnaire Status at ADMISSION OPERATION Status at DISCHARGE Questionnaire 8 weeks post-OP 8 weeks - assessment Questionnaire 1 year post-OP 1 year - assessment

  10. WHAT? QUALITY????? PATIENT oriented Fitness for purpose MANAGEMENT oriented Value for money CARE oriented Medical perfection

  11. What do we do with our data? COMPARISON on NATIONAL LEVEL ?

  12. What do we do with our data? COMPARISON on NATIONAL LEVEL = • Uninformative for the clinician

  13. What do we do with our data? COMPARISON on NATIONAL LEVEL = • Uninformative for the clinician • Irrelevant for the patient

  14. What do we do with our data? COMPARISON on NATIONAL LEVEL = • Uninformative for the clinician • Irrelevant for the patient • Boring, for quality-minded professionals

  15. COMPARISON on CLINIC + INDIVIDUAL LEVEL ?

  16. COMPARISON ”IMPOSSIBLE” on CLINICAL + INDIVIDUAL LEVEL =

  17. COMPARISON ”IMPOSSIBLE” on CLINIC + INDIVIDUAL LEVEL = • because of …. • CASE MIX……… • POLITICS……… • MONEY………… • EGO……………. • TRADITIONS….. • ..anything goes..

  18. COMPARISON on CLINICAL + INDIVIDUAL LEVEL = YES WE CAN… • Comparable Patient Groups • Dynamic Benchmark

  19. COMPARISON on NATIONAL LEVEL

  20. COMPARISON on CLINICAL LEVEL version 2006 Einfache Prolapsoperationen

  21. COMPARISON on CLINICAL LEVEL version 2009 Einfache Prolapsoperationen Dynamic Benchmark

  22. COMPARISON on CLINICAL LEVEL version 2012 Einfache Prolapsoperationen

  23. What do we do with our data? Clinical data + ”Rapportgenerator” Production reports Scientific research ”for all” Special reports ”Open report” (Öppna Jämförelser) Pre-op information of patients Gyn. Departments ”annual report”

  24. Quality control  ain’t easy….. Thank you for listening! emil.nussler@gmail.com Swedish National Quality Register of Gynecological Surgery www.gynop.org

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