Page 18 - Shared Guideline Development Experiences in Fertility Care

Chapter 1
Patients and guideline-based quality indicator development
High-quality fertility care comprises more than just the e ectiveness of care. Regardless of medical-technical quality, patient-centredness also determines the quality of fertility care [13]. e patient-centredness of care comprises various aspects, such as the coordination and integration of care and the provision of emotional support [52,53]. Furthermore, professionals in the eld have been shown to be unable to adequately evaluate their performance regarding patient- centredness [54]. is inability hampers direct quality improvement regarding patient-centredness and illustrates the need for measurable elements of practice performance regarding this quality-of-care dimension. Since clinical practice guidelines recommend optimal patient care and are based on the best available evidence and consensus, guideline-based indicators are highly suitable for direct monitoring and improvement of the quality of care [13, 55, 56].
us far, several studies have reported on the development of guideline-based indicators within the eld of fertility care [57-59]. However, in these studies, a particular focus on the patient-centredness of fertility care has been lacking. Furthermore, the involvement of patients in the guideline and indicator- development process is still not common practice [2]. Only within the eld of cancer care has the development of guideline-based indicators for patient- centredness been reported [60,61]. Although patients played a minor role in these indicator-development panels, the results suggest that including patients leads to the identi cation of aspects of patient-centredness that may not have been considered previously. However, in these studies, the exact di erence in choice of indicators between professionals and patients regarding patient-centredness remains unexplored.
Current guidelines and related indicators in fertility care
In the past, both professional societies in the elds of reproductive medicine and governmental agencies have put major e orts into the development of CPGs for infertility. ese institutions include the American Society for Reproductive Medicine (ASRM), the European Society of Human Reproduction and Embryology (ESHRE), the National Institute of Clinical Excellence (NICE), and the Nordic Federation of societies of Obstetrics and Gynaecology (NFOG). By the time the studies in this thesis were conducted, the Dutch society of Obstetrics (NVOG) in the Netherlands had an extensive guideline program, including 17
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