[Measurement of the outcome quality as beginning of total quality management in otorhinolaryngology].
BACKGROUND
The last years are characterized by a change of paradigms in the evaluation of medical therapeutical strategies. The term quality of life (QoL) has been established in oncology and could be demonstrated as a subject of highly qualified investigations which were published during the last years. An extendend quality management is correlated with the possibility of cost-effectiveness measurement and arrangement in a time characterized by decreasing financial resources of the hospitals and university departments. The experiences in the field of quality analysis could offer precious tools to optimize structures, processes and results of treatments. This aim is strongly supported by the expected law "Gesundheitsreform 2000".


RESULTS
Therefore reliable, valid tools are needed to calculate the effects of therapies. The combination of global and specific questionnaires include the possibility to compare oncologic data of different entities of malignomas. A couple of questionnaires in otorhinolaryngology were developed in the last decade involving the fields of malignomas of the upper aerodigestive tract, rhinosinusitis etc.


CONCLUSIONS
Ishikawa, the founder of "Total Quality Management" and of the "Quality Circ", pointed out the high importance of customer satisfaction. Whereas the patient is in the mid point of medical treatment there are hardly any investigations about customer satisfaction published. Therefore it is necessary to develop and establish validated tools for the measurement of quality dimensions. The short, middle and long-lasting effects of a treatment could be calculated by quality of life measurements. The QoL is here of very strong importance, especially since economic aspects are included.
Klinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Christian-Albrechts-Universität zu Kiel. maune@hno.uni-kiel.de
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D005858:Germany; D006801:Humans; D010036:Otolaryngology / Q000592:standards*; D010039:Otorhinolaryngologic Neoplasms / Q000628:therapy*; D017060:Patient Satisfaction; D011788:Quality of Life; D012106:Research; D017749:Total Quality Management