06.10.2011National CQ Index-Hospitals survey makes healthcare quality transparent to hospitals, insurers and patients

The Consumer Quality Index-Hospitals (CQI-Z) is the first patient experience survey that makes healthcare in the Netherlands truly transparent to hospitals, health insurers and patients. The CQI-Z was initiated by Santeon – a national group of six top clinical hospitals - and the Miletus Foundation, a consortium of health insurers that measures patient experiences in healthcare. To their satisfaction, the Santeon hospitals have been working with the index for a year. Now, the online CQI-Z questionnaires have for the first time been used in a survey of all Dutch hospitals.

Health insurers already carry out a paper version of the CQ Index biannually, for the purpose of purchasing care, among a limited group of clinical patients. Recently, they used the online CQI-Z questionnaires for this. The results of the first national survey were presented today at a symposium - organised by Santeon and the Miletus Foundation – to hospitals, health insurers and patient organisations. The data collection of the national CQI-Z was carried out by the Miletus Foundation in the period June-July 2011 on both a clinical and outpatient-clinical level, using a digital questionnaire in all Dutch hospitals among approximately 55,000 patients. 

The results show that the Santeon hospitals generally score higher than other hospitals. With respect to hospital admission experiences, Santeon hospitals are particularly judged favourably on communication with doctors and nurses, explanation of treatment and the patient’s involvement. Santeon scores less well on the content of the pre-admission talk. As for outpatient-clinical visits, Santeon scores well on the treatment by doctors and other care providers. The information given by doctors is judged less favourably.

“These results are important to us. We can now see very specifically where improvements can be made and share our mutual know-how and experience. Thus, we as Santeon hospitals can continuously improve the quality of our care”; says Dr. Douwe J. Hemrika, chairman of the Executive Board of Onze Lieve Vrouwe Gasthuis and chairman of the board of Santeon.

CQI-Z is innovative, shorter, faster and more custom-made
Before the CQI-Z, comparing hospitals was hard because hospitals, health insurers, comparison sites and patients’ associations measure patient experiences by different methods. This triggered Santeon and the Miletus Foundation - supported by the Federation of Patients and Consumer Organisations in the Netherlands (NPCF) – to develop a new version of the CQ index in 2010 which was shorter, faster and more custom-made. Because hospitals and health insurers apply the same methodology, it leads to transparency in the quality of care. The clinical and outpatient-clinical experiences of a large group of patients are charted: for the entire hospital, on a location, speciality, (main) diagnosis and DBC level. On all these criteria, the Santeon hospitals can compare themselves, learn from each other and improve their care; health insurers can use the benchmark information to purchase good healthcare; patients can use the data to decide which hospital they want to be treated in. The results are immediately available online for hospitals, unlike the ‘old’ paper CQ index, the data of which were only available at a later stage, and therefore often outdated.

CQI-Z also for other hospitals
After the successful trial survey with the CQI-Z among Santeon hospitals in late 2010, Santeon and the Miletus Foundation entered into a contract to keep using and developing this instrument in the long term.
Other hospitals can join, too, and structurally use the CQI-Z and measure patient experiences several times a year. This will produce sufficient large-scale sample surveys to obtain reliable and valid control information on a hospital and speciality level. The CQI-Z benchmark report is drawn up annually. Hospitals that do not actively apply for the CQI-Z remain dependent on the national surveys executed by the healthcare insurers, who have smaller sample surveys and only provide limited information for the hospital’s internal improvement management.