Joint development of clinical practice guidelines and qualityindicators as a tool for quality of care improvement

Methodology development was possible in part due to Internal Grant Agency of the Ministry of Health Contract IGA, No. 10650-3. Structured process methodology of joint development of clinical practice guidelines (CPG) and indicators of quality and efficiency of health care (QI) is presented. During preparatory and design phase know-how of organizations (AHRQ, HAS, SIGN) were extensively used and applied to functional components of Czech healthcare system. We use a proprietary methodology, "lifecycle development", EBM, algorithm design, recommendations of clinical criteria and process indicators based on rigorous analysis of the shortcomings of Czech healthcare. Czech healthcare uses an extensive database of "administrative" (care reimbursement) and clinically specific (clinical registries) data which we use to design and test QI in defined coordination with CPG development process. Paper provides information on systemic solutions and presents concrete examples from oncology. It is known that only a small number of CPG producing organizations have a formal procedure for simultaneous development of QI in place. Our methodology facilitates healthcare processes management and supports healthcare stakeholders.