Health Care Quality
Zorginstituut Nederland (National Health Care Institute) encourages good health care by helping all the parties involved to continually improve health care quality and by helping patients find their way to high quality care.
Patients, clients, care-providers and health insurers are exceptionally knowledgeable about what represents good health care and how to measure its outcomes. Their joint consultations result in agree- ments on good health care which are incorporated into quality standards. If the parties, for whatsoever reason, are unable to reach an agreement, Zorginstituut Nederland can draw up a standard. In executing its work in the field of good health care, the Zorginstituut is assisted by a Quality Board comprised of ten external experts from various fields of health care.
Improving the quality of care starts with the question: what is good care? Good care is not just about healing or preventing deterioration; it is also about informing patients and involving them in decisions on choice of treatment or care. The definition of good care for a given disorder is incorporated in a quality standard. Such a standard describes, for every disorder, how an indication is established, what care is available and how the care process is organised. A quality standard is based not only on the most recent scientific insights into medical aspects of care or factors that determine quality of life, but also on ways in which patients are involved in their treatment and which choices are open to them. A layman’s version of every quality standard should be made available for consumers of health care.
Zorginstituut Nederland is compiling an overview of care standards, guidelines, examples of good practices and indicators that will clearly show which quality standards and instruments of measurement are still lacking. Standards are assessed in the light of criteria stipulated by the Zorginstituut. Standards that fulfil these criteria are included in a special Register where everyone can read about the agreements made. Zorginstituut Nederland’s criteria cover such matters as: were all relevant parties, including patients, involved in drawing up the standard and is a layman’s version of the standard available? The Register can be found on www.zorginzicht.nl. This website’s knowledge-bank helps professionals to develop quality instruments.
Making quality transparent
Care-providers measure outcomes of care so we know whether patients are receiving care that complies with the agreed quality. Quality standards stipulate which data have to be measured and how often. Zorginstituut Nederland publishes this information on quality of care in a public database, www.zorginzicht.nl, which everyone can access.
There will always be aspects of health care quality that need improvement in the short term. Zorginstituut Nederland draws up a multi-year agenda in consultation with all parties involved in health care. On this agenda are care requirements that involve large numbers of people, disorders that lead to a high burden of disease or high care costs, and forms of care where quality is not optimal. In relation to these topics, Zorginstituut Nederland agrees with the health care parties which quality standards and instruments for measuring quality need to be provided, by which organisations, and when. If the parties fail to agree on the quality standards and measuring instruments, Zorginstituut Nederland can make use of its so-called overriding authority. This means the Zorginstituut takes charge of realising a standard, as it did in the case of the Quality Standard on Organising Intensive Care and the Care Standard for Integral Obstetric Care.