Formaliserte konsensusprosesser, veiledning ved vanskelige valg?

Abstract

ENGLISH: 1-page key messages

Indicators are one of many sources to knowledge about patient safety. Which indicators we choose to use, determine the picture we are painting. How these choices are made and documented, are important sources of information when the results of the indicators shall be interpreted and comprehended.

Many nations and international organizations use one or another form for formalized consensus processes in the development and choice of quality indicators for the health services. In this report we examine the principle behind the formalized consensus processes and describes one American method and two European tools which have been used for this purpose.

In Norway, there are little or no tradition for conducting formalized consensus processes when choosing indicators within the health services. By building on the knowledge from other land and organizations within this field, we can implant this method by relative simple means. Developing medical quality registries and national indicators can profit from implementing formal consensus processes. There will be an extra cost by introducing this technique, but in the long term, the knowledge base will be sounder and less time used on developing and validating the indicators.

Documentation of consensus processes provide extensive information about each single indicator and how it is considered within the medical environment. Strength and weaknesses for the indicators are documented, and are important background information for interpreting the results when the indicators are used. High cost for data collection may lead to exclusion of indicators, this is important knowledge to get the whole picture of information about sets of indicators. Transparency about indicator selection and the consequences of them are important factors in improving the understanding and use of quality indicators for the health services.