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Quality Circles - A Well Established Instrument of
Continuous Medical Education and Quality Improvement
in Germany
EQuiP Meeting, 25th April, 2015
Ingrid Quasdorf, Senior Referent, NASHIP, Berlin
Dr. Stephan Gotsmich, General Practitioner, Landshut
EQuiP Meeting  24./25.04.2015  Seite 2
National Association of Statutory Health Insurance
Physicians (NASHIP) Berlin
www.kbv.de
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National organisation of about 153,000 outpatient doctors and
psychotherapists; based on the social code (§ 77 Abs. 4 SGB V)
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Members: 17 regional Associations of Statutory Health Insurance Physicians
(ASHIP)
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Tasks: stands for the interests of their members politically as well as
economically; concludes contracts with the statutory health insurances and
guarantees the quality of medical performance
EQuiP Meeting  24./25.04.2015  Seite 3
Quality in Outpatient Health Care Is Based on ….
• e. g. social code - book V
law
legal
norms
• e. g. for accreditation of medical doctors
• e. g. agreements on quality assurance with health insurances
contract • Disease Management Programs
individual
initiatives
• quality circles
• peer reviews
• regional quality projects
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How Do Quality Circles Usually Work in Germany?
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5-20 participants
Qualified moderators
Peer groups
Based on their own knowledge and experiences; using external evidence
Continuous (minimum 4 sessions a year)
Self-determined - choosing their own subjects and methods
What Is the Benefit?
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Useful for doctors as well as
patients
Quality improvement
Implementation of evidence and
medical innovations into
practices
Continuous medical education
Networking
Increasing job satisfaction
Analysis
Subjects
Objectives
Advancement
Quality Improvement
Evaluation
Act
Plan
Check
Do
Critical Reflection
Transformation
Implementation
Documentation
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Statistical Data (2013)
8,866 circles nationwide
68,000 participants
7,034 moderators
86 so-called tutors
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Types of Quality Circles
General practitioners
Specialists
Psychotherapists
Other professional categories
Cross-sectoral
Different specialists
Other categories
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How Does NASHIP Support Quality Circles?
NASHIP
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Train-the-trainer-concept for tutors
Curricula (modules)
Tools
Information
Co-ordination
Marketing
Communication
Meetings
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NASHIP Concept for Quality Circles
NASHIP
Education of tutors
Further training
Supervision
•
Curricula for circle work
•
Tools like slides, poster, handouts (CD-ROM)
ASHIP
Education and further
trainings for
moderators by tutors
train-the-trainer-prinziple
Curricula -
NASHIPP
Tutors developement
training
and
EQuiP Meeting  24./25.04.2015  Seite 9
ASHIP Support
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Financial support
Logistical support
Training of moderators
Further education
Meetings (exchange of experiences)
Information
Communication
Services
EQuiP Meeting  24./25.04.2015  Seite 10
Education of Tutors
Part I*
Role of tutors
Moderation of groups
Training of case discussions
Part II*
Evidence based medicine
Guidances
Patient information
Part III*
Training - using the curricula
of the NASHIP manual
* 2 days
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NASHIP Manual „Handbuch Qualitätszirkel“
Chapter 1+2
Introduction, instructions, overview
Chapter 3
Leading groups
Chapter 4
Curricula
 Case discussion
 Patient safety
 Differential diagnostics
 Evidance based
medicine/guidances
 Hygiene management
 Feedback systems
 Interviewing professionals
 Journal club
 Coaching
 Quality indicators
 Evidance based patient
information
 Making practices
accsessibly
 Pharmacotherapy
 Gendermedicine
…
Chapter 5
Quality management QEP®
Chapter 6
Education of moderators, foundation of quality circles
EQuiP Meeting  24./25.04.2015  Seite 12
Curriculum „Hygiene Management“
General Aspects
Tools
Objectives
Background information
Data and information
Setting
Links and literature
Presentations
Moderation posters
Checklists
Document samples
Session I
Checklist Hygiene
1. Introduction – legal fundamentals,
responsebilities
2. Practice plan for hygiene
3. Measures for the practice hygiene
management
Session II
1. Implementation of practice hygiene
management
2. Preparation for inspection
Further sessions
e. g. re-conditioning of medical devices
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How Does A Tutor Work?
 With a lot of fun
 Voluntarily
 Mandated by the self-government in
outpatient health care
 Motivating his colleagues
 As a trainer
 Giving new inputs into circle work
 Creative
 As an author of new modules of the
circle concept
 Nationwide or regional
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Current Discussions
 How can young doctors are obtained for quality circle?
 Are quality circles also an option for employed doctors?
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Further information: http://www.kbv.de/html/qualitaetszirkel.php
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Video Clip: Establishing a Quality Circle
www.KBV.de
EQuiP Meeting  24./25.04.2015  Seite 17
NASHIP Quality Report
www.KBV.de
EQuiP Meeting  24./25.04.2015  Seite 18
Thank you for your attention!
Please contact: [email protected]
+49 30 4005-1230