Universität zu Köln

Derendorf, Lisa ORCID: 0000-0003-0213-9471 (2024). Development, Implementation and Evaluation of a Quality Management System for Cross-Sectoral Psycho-Oncological Care in Germany. PhD thesis, Universität zu Köln.

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Abstract

Introduction. High-quality psycho-oncology care enhances patients' satisfaction, adherence to treatment, and overall well-being. Because in Germany rendering consistent care faces difficulties such as fragmented health care systems, integrating a quality management system may address these challenges by ensuring consistent, evidence-based care, enhancing interprofessional collaboration, continuously improving quality, and optimising resource allocation. Objectives. The dissertation aims to develop, implement, and assess a quality management system for a multidisciplinary psycho-oncology approach care. Special attention is given to the development of quality indicators, the use of a participatory quality development approach, and the evaluation of the proposed concept. The purpose of this dissertation is to advance the furtherance of psycho-oncological care in Germany by identifying and assessing prospective measures and a quality management framework. Methods. An embedded mixed methods design was implemented with a focus on quantitative data. Quality indicator development was based on the RAND/UCLA Appropriateness Method in combination with a Delphi technique. Participatory tools were used in the continuous improvement process, and the level of participation was assessed through a longitudinal survey. To evaluate the implementation of the quality management system, a utility analysis was carried out. Results. A profound quality management system has been put in place comprising structural and procedural tools that cater to both internal and external necessities. A set of 16 quality indicators was operationalised and reviewed for relevance, comprehensibility, and suitability. The findings showcase that integrating a sustainable participatory quality development process into the quality management system is feasible but certain difficulties were also identified. The evaluation of the implementation of the quality management systems resulted in a utility score of 4.2 out of 5.0 (84.0%), indicating successful implementation. The implementation of top-down elements, such as contracts and manuals, was comprehensive, whereas bottom-up aspects, such as quality circles, presented more challenges. Conclusion. This dissertation successfully implemented a robust quality management system to enhance psycho-oncological care, achieving key objectives such as developing and digitally integrating comprehensive quality indicators. Despite successful stakeholder engagement, challenges in balancing bottom-up dynamics with top-down structures were identified, highlighting the crucial role of active leadership. The study underscores the importance of quality management, especially in the context of digital transformation and psycho-oncological care, emphasizing the need for further research on cost-effectiveness and implications of digital transformation.

Item Type:	Thesis (PhD thesis)
Translated title:	Title Language Entwicklung, Implementierung und Evaluation eines Qualitätsmanagementsystems für die sektorenübergreifende psychoonkologische Versorgung in Deutschland German
Creators:	Creators Email ORCID ORCID Put Code Derendorf, Lisa l.derendorf@googlemail.com https://orcid.org/0000-0003-0213-9471 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-727755
Date:	2024
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Gesundheitsökonomie > Institut für Gesundheitsökonomie und Klinische Epidemiologie
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language Quality management, psycho-oncology, integrated care, quality indicators, quality development, participation, cancer English Qualitätsmanagement, Psychoonkologie, integrierte Versorgung, Qualitätsindikatoren, Qualitätsentwicklung, Partizipation, Krebs German
Date of oral exam:	8 May 2024
Referee:	Name Academic Title Kusch, Michael PD Dr. Voltz, Raymond Prof. Dr.
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/72775