Development of a quality standards on allergology for German physicians

Article type
Authors
Ollenschlager G, Thomeczek C, Mohr W
Abstract
Introduction/Objective: As a consequence of health care deficiencies in allergology, the Agency for Quality in Medicine was commissioned to develop quality standards on allergology. We describe the standardized development process of the AQM for quality standards of German physicians, initiated in 1996 in favor of consideration of scientific evidence, practicability and transparency during the development process.

Methods: The AQM initiated a 10 step program for the development of quality standards, Step 1: Nomination of a steering committee representing the official representatives of the relevant medical societies. Step 2: Defining the deficiencies (using data basis of medical societies and self-governmental bodies). Step 3: Investigating the evidence (Searching in national and international databases). Step 4: Developing a first draft on measures for quality assurance / improvements with respect to structures and processes in allergology. Step 5: Communication the draft with all medical societies, insurance companies, self governmental and governmental bodies, consumer initiatives. Step 6: Compiling commentaries and recommendations from step 5. Step 7: Public hearing on draft and commentaries / recommendations. Step 8: Revision of First Draft consideration evidence based informations from step 6 and 7. Step 9: Deducing quality indicators and criteria from the recommendations of the standard. Step 10: Passing the standard as part of the professional code of the German Medical Association as well as entering into contract between the National Association of Statuatory Health Insurance Physicians and the Association of Statuatory Health Insurances.

Results: In 1995, the AQM was commissioned to develop the allergology standard, as a consequence of (1) immunotherapy related deaths, and of (2) not evidence based diagnostic procedures in German practices. The standard was developed from 3/96 to 3/97. During the revision of the first draft, about 90 different recommendations for change were considered.

Discussion: The 10-step program for developing quality standards of the self-governmental bodies of German physicians, was tested practicable and acceptable.