Guideline-based quality assurance: a conceptual framework for the definition of key elements

Area of Science:

• Healthcare Quality Improvement
• Clinical Guidelines
• Health Services Research

Background:

• The European Commission's Joint Research Centre (JRC) initiated a framework for guideline-based quality assurance (QA) to enhance cancer care.
• Inconsistency in terminology for QA and its relation to guidelines was identified.
• This article proposes a conceptual framework to integrate guideline and QA development.

Purpose of the Study:

• To propose a conceptual framework for integrated guideline and quality assurance (QA) development.
• To clarify terminology and definitions for key elements in guideline-based QA.
• To inform the European Commission Initiative on Colorectal Cancer (ECICC).

Main Methods:

• A multidisciplinary group of 23 experts participated in a mixed-methods approach.
• Methods included face-to-face dialogue and virtual meetings.
• A systematic literature review identified the absence of existing frameworks.

Main Results:

• A framework connecting quality indicators, performance measures, and performance indicators with guideline development was established.
• Quality indicators guide monitoring and improvement of healthcare structure, process, and outcomes.
• Performance indicators are quantifiable measures guided by guideline recommendations.

Conclusions:

• A standardized conceptual framework clarifies the role and interaction of key elements for healthcare quality improvement.
• The framework directly addresses health questions and recommendations within guidelines.
• Findings will be applied to the ECICC and future European Cancer Initiative updates for large-scale QA scheme implementation.