[Design of a set of indicators for 'Do Not Do' recommendations]

There is a growing interest in the optimisation of health care that has fostered and developed initiatives advocating more efficient and safe health care.

To determine indicators set for assessing the 'Do Not Do' Recommendations (DNDR) in a Spanish health area, in order to set interventions in motion for improving the quality of care and the patient safety.

The DNDR published by the health care organisation in 2016 were identified, and those that could be analysed were designed and tested using two assessment methods (if possible, directly from the whole data or, if not, by applying the lot quality assurance sampling - LQAS) and 2016 data from a Spanish health area. Both validity and reliability of these indicators were checked.

Of the 271 DNDR identified, 25 (9.3%) were prioritised and their corresponding quality indicator designed. From them, 80% were obtained directly, whereas the rest required LQAS. The interobserver agreement was very high. Efficiency was the quality dimension most frequently involved.

In order to improve the quality of care in terms of adequacy, safety, and sustainability, to assess the DNDR is possible, compulsory, and urgent. Thus, a set of valid, reliable and useful indicators has been designed. This set is focused on identifying improve opportunities and making it possible to approach them.