title: Development and use of guideline-derived quality indicators for community lymphoedema.
abstract: BACKGROUND
  Treatment of lymphoedema is complex and needs specific skills. There are no standards for the evaluation of quality of care.
  
  
  OBJECTIVE
  Development and application of indicators for the measurement of quality of care in lymphoedema.
  
  
  METHODS
  In a three-step process including a national Delphi expert consensus, quality indicators were derived from national and international guidelines. In a cross-sectional study involving a large spectrum of care providers, the quality of lymphoedema care in the community was assessed by transforming the indicators to one unweighted quality index (QI).
  
  
  RESULTS
  A total of 12 quality indicators were identified and applied to n = 348 patients with lymphoedema and lipolymphoedema of any origin in the metropolitan area of Hamburg (90.8% female, mean age 57, SD 14.5 years). On average, 55% of the quality indicators were met, and 64.8% of the patients were satisfied with lymphoedema care. There was a significant correlation between QI and satisfaction.
  
  
  CONCLUSIONS
  The quality indicators and the QI are feasible and valid for the evaluation of quality of care. They can support optimizing lymphoedema care.
authors.affiliation: CVderm - German Center for Health Services Research in Dermatology, University Clinics of Hamburg, Germany. k.herberger@uke.de
authors.forename: K
authors.initials: K
authors.lastname: Herberger
authors.forename: A K
authors.initials: AK
authors.lastname: Heyer
authors.forename: C
authors.initials: C
authors.lastname: Blome
authors.forename: A
authors.initials: A
authors.lastname: Sandner
authors.forename: F
authors.initials: F
authors.lastname: Altheide
authors.forename: M
authors.initials: M
authors.lastname: Lader-Holtorf
authors.forename: M
authors.initials: M
authors.lastname: Augustin
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care