van den Heuvel Henricus
Medical Centre Guetersloh, Nordrhein-Westfalen, Germany.
Qual Prim Care. 2011;19(3):183-91.
The Quality and Outcomes Framework (QOF) has had a major impact on the quality of care in British general practice. It is seen as a major innovation amongst quality indicator systems and as a result various countries are looking at whether such initiatives could be used in their primary care. In Germany also the development of similar schemes has started.
To propose a strategy indicating key issues for the implementation of a quality indicator scheme in German primary care.
Literature review with a focus on the QOF and German quality indicator literature.
There are major differences between the German and British healthcare and primary care systems. The development of quality indicator systems for German general practice is in progress and there is a net force for the implementation of such systems. The following ten key factors are suggested for the successful implementation of such a system in German primary care: involvement of general practitioners (GPs) at all levels of the development, a clear implementation process, investment in practice information technology (IT) systems, an accepted quality indicator set, a quality indicator setting institution and data collection organisation, clear financial and non-financial incentives, a 'practice registration' structure, an exception reporting mechanism, delegation of routine clinical data collection tasks to practice assistants, a stepped implementation approach and adequate evaluation processes.
For the successful implementation of a quality indicator system in German primary care a number of key issues, as presented in this article, need to be taken into account.
质量与结果框架（QOF）对英国全科医疗的护理质量产生了重大影响。它被视为质量指标体系中的一项重大创新，因此各国都在审视此类举措是否可用于其初级医疗。在德国，类似计划的制定也已启动。
提出一项战略，指明在德国初级医疗中实施质量指标计划的关键问题。
聚焦于QOF及德国质量指标文献进行文献综述。
德国和英国的医疗保健及初级医疗体系存在重大差异。德国全科医疗质量指标体系的开发正在进行中，且存在实施此类体系的一股合力。为在德国初级医疗中成功实施此类体系，建议考虑以下十个关键因素：在开发的各个层面让全科医生参与，明确的实施流程，对诊所信息技术（IT）系统的投资，一套公认的质量指标，一个质量指标设定机构和数据收集组织，明确的财务和非财务激励措施，一种“诊所注册”结构，一个例外报告机制，将常规临床数据收集任务委托给诊所助理，分阶段实施方法以及适当的评估流程。
为在德国初级医疗中成功实施质量指标体系，需要考虑本文提出的若干关键问题。
