Designing a Method with Physician Participation to Assess and Improve Quality of Healthcare in Otolaryngology

Abstract

Original Article INTRODUCTIONPrior to 2002, the Spanish National Health System assigned healthcare centers to citizens based on their place of residence. In 2002, the Patient Autonomy Act recognized a patient's right to freely choose a healthcare center, hospital, family physician, or specialist, independent of their place of residence. In addition, the Act established the patient's right to receive bona fide information about healthcare centers, hospitals, and physicians on which to base their choice [1] . Today, a considerable number of patients in Spain exercise their right to choose a hospital and physician. However, information to make an informed choice is scarce, not easily accessible, and not easy to interpret for the general public. In order to fully implement the Patient Autonomy Act, methods need to be developed that objectively evaluate the quality of care and that provide information to the public in an accessible, comprehensible way.The most common models for the quality assessment and performance management of hospitals are the European Foundation for Quality Management Model, International Standards Organization Certification, and Joint Commission Accreditation Model [2][3][4][5] . These models offer a general philosophy and ethical framework for the provision of healthcare, as well as suggestions for improving the quality of care; however, they do not provide information on the quality of care within specific medical departments. It is precisely this type of information that patients need in order to make correct informed choices regarding the best hospital or physician for their specific disease.The goal to create a set of indicators that capture information about specific medical departments within a given healthcare center could be approached by examining patient medical records. In fact, indicators exist that use data from the minimum basic data set (MBDS). The MBDS extracts data from patient medical reports and codes it according to the International Classification of Diseases Catalog. MBDS provides specific information on the demographics, diagnostics, and procedures in each hospital. Quality-of-care in- 128Designing a Method with Physician Participation to Assess and Improve Quality of Healthcare in Otolaryngology OBJECTIVE: Patient choice of healthcare centers to be treated for specific diseases is compromised by the low accessibility of understandable information. Physicians are rarely involved in healthcare quality assessment, despite their potentially valuable input. The purpose of this study was to develop a methodology for evaluating the quality of care that specifically incorporates advice from medical specialists and provides accessible information for patients in search of high-quality healthcare. MATERIALS and METHODS:A pilot Delphi study was conducted among 28 Spanish otolaryngology experts, seeking their opinion on the quality-of-care indicators and on their ability to recommend the most suitable department for the treatment of specific otolaryngologic diseases. RESULTS:The av...

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