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Background <p>Day hospices are an emerging component of outpatient palliative care in Germany. However, a standardized quality management system utilizing defined quality indicators has not yet been implemented. This study aimed to develop a new set of quality indicators for day hospices.</p> Methods <p>Through a multi-phase, quality-assured review, we screened validated quality indicators from German-language S3 guidelines and established quality indicator sets, including the Quality Indicator System for Outpatient Care (QISA) and Outpatient Quality Indicators and Key Figures (AQUIK) based on defined criteria for their relevance to day hospices. Selected indicators were analyzed by a validated and operationalized evaluation tool (QUALIFY) for their applicability to day hospices by an expert panel and subsequently finalized through a nominal group process.</p> Results <p>A total of 19 quality indicators, suitable for quality assurance of day hospices were identified from 482 potential quality indicators drawn from 29 S3 guidelines and 11 quality indicator sets. Of these, 13 indicators pertained to process quality, while 6 addressed structural quality. Indicators for the outcome quality were either not available or not suitable for a day hospice. The 463 not selected indicators were excluded mainly due to possible mismanagement or lack of reference to the goals and tasks of a day hospice.</p> Conclusions <p>The newly developed quality indicator set provides a robust framework for assessing and comparing the quality of care in German day hospices. Nevertheless, ongoing refinement and practical evaluation are necessary to ensure its relevance and effectiveness in routine clinical settings.</p> Trial registration <p>The study was registered as part of the IMPULS-Study in the German Register of Clinical Studies (DRKS-ID: DRKS00031613; Date of registration: 04 April 2023) and the Display portal of the Center for Clinical Studies of the University Hospital Regensburg (Z-2022-1734-6; Date of registration: 01 October 2022).</p>

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Development of a quality indicator set for day hospices in Germany – a multi-stage, quality-assured review of German guidelines and quality indicator sets

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  • 发表日期：

    2025年10月15日

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  • Ulrich Kaiser,
  • Ursula Vehling-Kaiser,
  • Ana Hoffmann,
  • Felix Kaiser,
  • Michael Rechenmacher,
  • Eleène Kaiser,
  • Romina Chalupper,
  • Moritz Fiedler,
  • Florian Kaiser

摘要

Background

Day hospices are an emerging component of outpatient palliative care in Germany. However, a standardized quality management system utilizing defined quality indicators has not yet been implemented. This study aimed to develop a new set of quality indicators for day hospices.

Methods

Through a multi-phase, quality-assured review, we screened validated quality indicators from German-language S3 guidelines and established quality indicator sets, including the Quality Indicator System for Outpatient Care (QISA) and Outpatient Quality Indicators and Key Figures (AQUIK) based on defined criteria for their relevance to day hospices. Selected indicators were analyzed by a validated and operationalized evaluation tool (QUALIFY) for their applicability to day hospices by an expert panel and subsequently finalized through a nominal group process.

Results

A total of 19 quality indicators, suitable for quality assurance of day hospices were identified from 482 potential quality indicators drawn from 29 S3 guidelines and 11 quality indicator sets. Of these, 13 indicators pertained to process quality, while 6 addressed structural quality. Indicators for the outcome quality were either not available or not suitable for a day hospice. The 463 not selected indicators were excluded mainly due to possible mismanagement or lack of reference to the goals and tasks of a day hospice.

Conclusions

The newly developed quality indicator set provides a robust framework for assessing and comparing the quality of care in German day hospices. Nevertheless, ongoing refinement and practical evaluation are necessary to ensure its relevance and effectiveness in routine clinical settings.

Trial registration

The study was registered as part of the IMPULS-Study in the German Register of Clinical Studies (DRKS-ID: DRKS00031613; Date of registration: 04 April 2023) and the Display portal of the Center for Clinical Studies of the University Hospital Regensburg (Z-2022-1734-6; Date of registration: 01 October 2022).