Qualitätsmanagement an der Klinik für Augenheilkunde des Universitätsklinikums Freiburg: Was nutzt das Erheben von Qualitätsparametern?

Abstract

All hospitals in Germany have a legal obligation to carry out internal quality management (QM). This means enormous costs as well as a burden for the employees through QM-specific tasks. The benefits can be advertising through certification, higher quality and safety for the treated patients and thus greater patient and employee satisfaction. The aim of this work is to compare effort and benefit of a QM system in ophthalmology. The surgical quality parameters already published in the annual reports, the available data of the QM handbook via the digital QM portal and patient feedbacks from 2004 to 2018/2019 were evaluated. In 2004, a quality management system was established for the first time in the Eye Centre at the Freiburg University Hospital. From 2005 to 2017, the entire hospital was KTQ-certified. In order to analyse the quality of surgery and patient safety, different surgical quality parameters were collected over the years with a constantly increasing number of operations. The majority of the quality parameters have remained stable or even decreased over the years. A peak in the postoperative endophthalmitis rate of 0.14% in 2015 and the decreasing percentage of cataract operations under topical anaesthesia in recent years were striking. The QM handbook was slimmed down. The analysis of clicks shows that the documents are increasingly used by the employees. The statistics of patient feedbacks show that this is a tool that is used quite frequently by patients to provide feedback on their stay and that the feedback is often positive. To operate quality management over many years, i.e. in our case to collect data of surgical quality parameters, to maintain the QM manual and to process patient feedbacks, means considerable effort. However, only the analysis of these parameters provides an insight into the current state of our clinic, from which conclusions can be drawn as to where processes or treatments can be optimised, which in turn can increase employee and patient satisfaction. Overall, transparency is increased and creates confidence for future treatments at the Eye Centre at the Freiburg University Hospital.