1. Quality Benchmarking and Dialog Dr. Christof Veit, Hamburg The Structured Dialog National Quality Benchmarking in Germany Annual Research Meeting 2006 Seattle

2. Quality Benchmarking and Dialog Benchmarking: The Principle. Define good quality in health care, measure and improve it in all hospitals involved nationwide.

3. Quality Benchmarking and Dialog Benchmarking: The Principle. The enthusiastic ones: Involve. The neutral ones: Inform. Attract. The critical ones: Use their critique. The refusing ones: Make it unattractive.

4. Quality Benchmarking and Dialog Benchmarking: Size of the project. > 2,000 German Hospitals (> 98%) > 5,000 medical departments > 3 Mio cases in 2005 > 20% of all hospital cases in Germany > 300,000 Cases in Hamburg in 2005 > 300 Quality indicators in 26 areas of care > 800 experts involved (national and regional)

5. Quality Benchmarking and Dialog Benchmarking: The Idea. improve and check define standards (evidence based, public) document processes, risks and results present variation define levels of acceptance start structured dialog

6. Quality Benchmarking and Dialog Benchmarking: The Participants. Federal Joint Committee G-BA National Institut BQS National Expert Groups National Data Base Hospitals State Project Office State Expert Groups State Data Base State Steering Committee Hospitals (central projects) Structured dialog data transfer regional national

7. Quality Benchmarking and Dialog Project Office Experts

8. Quality Benchmarking and Dialog Project Office Experts numerical outliers

9. Quality Benchmarking and Dialog Project Office Experts qualitative outliers Correct! Check! Steering Committee National Committee and National Experts Structured Report

10. Quality Benchmarking and Dialog Project Office Experts regional meetings Variation! Best practice! Improve! Check!

11. Quality Benchmarking and Dialog Benchmarking: Projects. 26 Projects on the National Level e.g. Hip- and Knee Replacement Cholecystectomy Gynaecological Operations Breast Cancer Operations Obstetrics Cardiac Pace Makers Coronary Catheters Heart Surgery Decubital Ulcers Pneumonia.........and others

12. Quality Benchmarking and Dialog Benchmarking: Questions. data validity risk adjustment confidentiality public quality report improvement instead of league tables

13. Quality Benchmarking and Dialog Benchmarking: Results. Due to upcoming publication only a small part of results can be shown here. Yet on personal request more data can be made available. Thanks for your understanding. c.veit @ EQS.de

14. Quality Benchmarking and Dialog

15. Benchmarking: Results. Antibiotic Prophylaxes and Wound infection in Hip-Replacement 2001 – 2004 Hamburg Hospitals, 3.500 cases per year

16. Quality Benchmarking and Dialog Improvement. Hamburg: Antibiotic Prophylaxes in Hip-Replacement. 2003: 95,6% % Hospitals 2004: 98,5%

17. Quality Benchmarking and Dialog Benchmarking: Future. longterm outcome interactive internet with trend analysis problem focus participant cooperation public information

18. Quality Benchmarking and Dialog Features for success. commitment of the big players in health care involvement of existing institutions methodology, transparency and fairness fixed framework, flexible machinery, efficient decisions commitment to improvement resist secondary interests

19. Quality Benchmarking and Dialog Thanks for your attention. c.veit @ EQS.de