[Effects of quality assurance measures on surgical gynecology treatment]

Basing on the example of the project "Quality assurance in gynaecological surgery", we show which effects due to participation in an externally supported quality assurance measure can be reached short-term. 44 gynaecological clinics documented 42,433 operative procedures within the project in 1994. In 1995, seven participants continued the documentation (9,430 operations). We measured the quality of care over time, using 20 quality indicators that were formulated in the project. Quality improvements were achieved in the two-year study period particularly for indicators which focused on less complex processes of care (i.e. thromboprophylaxis with heparin). However, more complex processes of care, such as the indication for an operation, have not yet changed. Nevertheless, according to the results of structured interviews, we expect long-term quality improvements: due to the participation in the project, 26 clinics reported increasing attention to the quality of care, 12 clinics changed their organisation of the quality assurance system and 11 clinics began internal quality improvement projects on the basis of the study benchmarks.