title: Defining and improving quality management in Dutch diabetes care groups and outpatient clinics: design of the study.
abstract: BACKGROUND
  Worldwide, the organisation of diabetes care is changing. As a result general practices and diabetes teams in hospitals are becoming part of new organisations in which multidisciplinary care programs are implemented. In the Netherlands, 97 diabetes care groups and 104 outpatient clinics are working with a diabetes care program. Both types of organisations aim to improve the quality of diabetes care. Therefore, it is essential to understand the comprehensive elements needed for optimal quality management at organisational level. This study aims to assess the current level of diabetes quality management in both care groups and outpatient clinics and its improvement after providing feedback on their quality management system and tailored support.
  
  
  METHODS
  This study is a before-after study with a one-year follow-up comparing the levels of quality management before and after an intervention to improve diabetes quality management. To assess the status of quality management, online questionnaires were developed based on current literature. They consist of six domains: organisation of care, multidisciplinary teamwork, patient centeredness, performance management, quality improvement policy and management strategies. Based on the questionnaires, respondents will receive feedback on their score in a radar diagram and an elucidating table. They will also be granted access to an online toolbox with instruments that proved to be effective in quality of care improvement and with practical examples. If requested, personal support in implementing these tools will be available. After one year quality management will be measured again using the same questionnaire.
  
  
  CONCLUSIONS
  This study will reveal a nationwide picture of quality management in diabetes care groups and outpatient clinics in the Netherlands and evaluate the effect of offering tailored support. The operationalisation of quality management on organisational level may be of interest for other countries as well.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Heidelberglaan 100, 3508, GA Utrecht, The Netherlands. m.j.e.campmans-kuijpers@umcutrecht.nl
authors.forename: Marjo J E
authors.initials: MJ
authors.lastname: Campmans-Kuijpers
authors.forename: Lidwien C
authors.initials: LC
authors.lastname: Lemmens
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Baan
authors.forename: Kees J
authors.initials: KJ
authors.lastname: Gorter
authors.forename: Jolanda
authors.initials: J
authors.lastname: Groothuis
authors.forename: Klementine H
authors.initials: KH
authors.lastname: van Vuure
authors.forename: Guy E H M
authors.initials: GE
authors.lastname: Rutten
mesh_terms: D000554:Ambulatory Care Facilities; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D033183:Interdisciplinary Communication; D009426:Netherlands; D010348:Patient Care Team / Q000458:organization & administration; D058996:Quality Improvement; D011787:Quality of Health Care / Q000458:organization & administration*; D011795:Surveys and Questionnaires
references.citation: Lancet. 2011 Jul 2;378(9785):31-40
references.pmid: 21705069
references.citation: N Engl J Med. 2010 Oct 7;363(15):1389-91
references.pmid: 20925539
references.citation: Health Aff (Millwood). 2001 Nov-Dec;20(6):64-78
references.pmid: 11816692
references.citation: Int J Qual Health Care. 2002 Apr;14(2):91-101
references.pmid: 11954688
references.citation: N Engl J Med. 2008 Mar 6;358(10):1064-71
references.pmid: 18322289
references.citation: Int J Qual Health Care. 1999 Apr;11(2):119-30
references.pmid: 10442842
references.citation: N Engl J Med. 2009 Aug 6;361(6):551-3
references.pmid: 19657119
references.citation: N Engl J Med. 2011 Mar 17;364(11):990-1
references.pmid: 21410368
references.citation: Lancet. 2012 Jun 16;379(9833):2252-61
references.pmid: 22683130
references.citation: BMJ. 2000 Dec 2;321(7273):1400-2
references.pmid: 11099288
references.citation: N Engl J Med. 2011 Jul 28;365(4):e6
references.pmid: 21751898
references.citation: Int J Qual Health Care. 2000 Jun;12(3):191-201
references.pmid: 10894190
references.citation: Int J Qual Health Care. 2009 Feb;21(1):66-75
references.pmid: 18945745
references.citation: Int J Qual Health Care. 2009 Oct;21(5):330-40
references.pmid: 19689988
references.citation: Int J Qual Health Care. 2003 Jun;15(3):223-34
references.pmid: 12803350
references.citation: Qual Manag Health Care. 1994 Summer;2(4):63-72
references.pmid: 10137609