Developing a national continuous quality improvement system for neuromodulation treatment in The Netherlands.
BACKGROUND
Because neuromodulation was not included in the national health insurance system, the Dutch Neuromodulation Group (DNG) developed national standards and a continuous quality improvement (CQI) system for consistency in application of neuromodulation techniques and in the quality of outcomes.
A stepwise approach was used in which the following ten steps were taken: (1) selected participating medical specialists and their centers, (2) described the treatment protocol, (3) collected data in a national database, (4) organized feedback sessions for the DNG, (5) formulated quality indicators, (6) adjusted the process of treatment, (7) formalized the structure of the DNG, (8) defined responsibilities, (9) established procedures for future development, and (10) made agreements with payers.


CONCLUSIONS
Making reimbursement for expensive health care interventions contingent on a national CQI system created a powerful financial incentive to continuously provide effective care in an efficient manner.
Beersen
Nicoline
N
Institute of Health Policy and Management, Erasmus University Medical Center Rotterdam (EMCR), The Netherlands. beersen@bmg.eur.nl
Bart de Bruijn
J H
JH
Dekkers
Monique A
MA
Ten Have
Pieter
P
Hekster
Gideon B
GB
Redekop
W Ken
WK
Spincemaille
Geert H
GH
Theuvenet
Peter J
PJ
Berg
Marc
M
Klazinga
Niek S
NS
D000776:Anesthesiology; D004558:Electric Stimulation; D006801:Humans; D009426:Netherlands; D059408:Pain Management; D017410:Practice Guidelines as Topic; D013116:Spinal Cord / Q000503:physiopathology*; D017749:Total Quality Management