Page 154 - Shared Guideline Development Experiences in Fertility Care

Chapter 7
goal of clinical practice guidelines is to optimize the quality of care and guideline- based indicators are being developed to monitor the adherence to them.
Quality indicators can focus on the process, structure, or outcome of care, including important domains of the patient-centredness of care. However, patients are, for the most part, surprisingly not involved in the development process of guideline- based quality indicators. Guideline-based indicators are usually developed by panels of experts, who may be unable to adequately evaluate their performance regarding patient-centredness [41].
e study in Chapter 6 showed that infertile patients can broaden a set of guideline- based quality indicators for fertility care by selecting di erent indicators representing di erent domains of patient-centred care (e.g. accessibility, coordination, and integration of care) than professionals select, which appeared earlier as underexposed dimensions of patient-centredness [60–65]. is nding strengthens the recommendation to involve patients in the guideline indicator development process. Following this recommendation is even more important in complex chronic conditions where a high adherence to treatment is inevitable. Nevertheless, there is still not an existing uniform methodological gold standard for patient involvement in the development process of quality indicators [66]. Additionally, the Netherlands is still facing challenges in measuring quality indicators, since adequate registration is lacking, and in determining responsibilities in the registration process. Furthermore, there is a tendency to develop all kinds of instruments to measure quality of care and, consequently, healthcare professionals may face a huge burden in registration load. To alleviate this burden, the e ective use of existing data and education on the importance of registering data and its value in improving the quality of care should be considered to be key factors in motivating professionals to pave the way to continuously improving the quality of care [67].
Methodological considerations
Setting of the studies
e majority of the studies included in this thesis were conducted within a national project aiming to innovate, broaden collaboration, and improve the level of patient-centredness in guideline development. is setting could in uence the results of our studies since participants were more committed to collaborate at rst.
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