Abstract
BackgroundWorldwide, the organisation of diabetes care is changing. As a result general practices and diabetes teams in hospitals are becoming part of new organisations in which multidisciplinary care programs are implemented. In the Netherlands, 97 diabetes care groups and 104 outpatient clinics are working with a diabetes care program. Both types of organisations aim to improve the quality of diabetes care. Therefore, it is essential to understand the comprehensive elements needed for optimal quality management at organisational level. This study aims to assess the current level of diabetes quality management in both care groups and outpatient clinics and its improvement after providing feedback on their quality management system and tailored support.Methods/designThis study is a before-after study with a one-year follow-up comparing the levels of quality management before and after an intervention to improve diabetes quality management. To assess the status of quality management, online questionnaires were developed based on current literature. They consist of six domains: organisation of care, multidisciplinary teamwork, patient centeredness, performance management, quality improvement policy and management strategies. Based on the questionnaires, respondents will receive feedback on their score in a radar diagram and an elucidating table. They will also be granted access to an online toolbox with instruments that proved to be effective in quality of care improvement and with practical examples. If requested, personal support in implementing these tools will be available. After one year quality management will be measured again using the same questionnaire.DiscussionThis study will reveal a nationwide picture of quality management in diabetes care groups and outpatient clinics in the Netherlands and evaluate the effect of offering tailored support. The operationalisation of quality management on organisational level may be of interest for other countries as well.
Highlights
Worldwide, the organisation of diabetes care is changing
This study will reveal a nationwide picture of quality management in diabetes care groups and outpatient clinics in the Netherlands and evaluate the effect of offering tailored support
We found seven models containing different domains of quality management (QM): the Chronic Care Model (CCM) [20]; the ‘Harmonisatie Kwaliteitsbeoordeling in de Zorgsector’ (HKZ: Harmonisation Quality Assessment in Health Care) model, based on ISO 9001 [21]; The Malcolm Baldrige USA National Quality Award (MBQA) [22]; The European Foundation for Quality Management (EFQM) [23]; the ‘Instituut Nederlandse Kwaliteit’ (INK: Institute for Dutch Quality) model from the Dutch Governmental foundation, based on the above mentioned EFQM [24,25]; and a measuring instrument developed by C
Summary
The organisation of diabetes care is changing. As a result general practices and diabetes teams in hospitals are becoming part of new organisations in which multidisciplinary care programs are implemented. In the Netherlands, 97 diabetes care groups and 104 outpatient clinics are working with a diabetes care program. Both types of organisations aim to improve the quality of diabetes care. The number of type 2 diabetes mellitus patients (T2DM) is rising rapidly [1] This poses great challenges to cost, efficacy and quality of diabetes care. DCGs are the main contractor of a diabetes care program, and are responsible for the organisation, coordination and delivery of diabetes care. They comprise between three and 250 general practitioners (GPs) [12]. Besides the DFHCS standard, the latter have special guidelines for treatment of a diabetic foot, retinopathy, nephropathy [6,14]
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