Assessment of quality guidelines implementation using a continuous quality improvement programme.
BACKGROUND
Data from the Dialysis Outcomes and Practice Patterns Study (DOPPS) study suggest that the level of implementation of the European Best Practice Guidelines (EBPG) is at best partial. The main aim of this study is to describe the level of implementation of the EBPG in the European Fresenius Medical Care (FME) clinic network.


METHODS
Data presented in this investigation were gained through the FME database EuCliD (European Clinical Database). Patient data from 4 countries (Great Britain, France, Italy, Spain) were selected from the EuCliD database. The parameters chosen were haemodialysis adequacy, biocompatibility, anaemia control and serum phosphate control, which are surrogate indicators for quality of care. They were compared, by country, between the first quarter (Q1) 2002 and the fourth quarter (Q4) 2005.


RESULTS
During Q1 2002 and Q4 2005, respectively, a total of 7,067 and 9,232 patients were treated in FME clinics located in France, Italy, Spain and the UK. This study confirms variations in haemodialysis practices between countries as already described by the DOPPS study. A large proportion of patients in each country achieved the targets recommended by the EBPG in Q4 2005 and this represented a significant improvement over the results achieved in Q1 2002.


CONCLUSIONS
Differences in practices between countries still exist. The FME CQI programme allows some of these differences to be overcome leading to an improvement in the quality of the treatment delivered.
Richards
Nick
N
Fresenius Medical Care UK, Tipton, UK. nick.richards@fmc-ag.com
Ayala
Juan Antonio
JA
Cesare
Salvatore
S
Chazot
Charles
C
Di Benedetto
Attilio
A
Gassia
Jean-Paul
JP
Merello
Jose-Ignacio
JI
Rentero
Ramon
R
Scatizzi
Laura
L
Marcelli
Daniele
D
D000328:Adult; D000368:Aged; D000740:Anemia / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D015415:Biomarkers; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D016208:Databases, Factual; D004363:Drug Utilization / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006269:Health Facilities, Proprietary / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D006436:Hemodialysis Units, Hospital / Q000706:statistics & numerical data; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration* / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care; D012042:Registries / Q000706:statistics & numerical data*; D006435:Renal Dialysis / Q000295:instrumentation / Q000379:methods / Q000401:mortality / Q000592:standards* / Q000706:statistics & numerical data
D015415:Biomarkers