QUA-DIT - Quality evaluation of hospital care through audits
Research Project | 01.01.2022 - 30.06.2025
Background: The recent increasing complexity in internal medicine and the concurrent demand for improving quality while cutting down resources represent a major challenge for healthcare providers. Disease-specific clinical guidelines for diagnostic and therapeutic management provide support in this demanding situation. However, according to previous studies, guideline adherence is often poor in clinical practice. Clinical audits are a powerful instrument in the evaluation of guideline adherence and can ultimately improve quality of hospital care.
Objectives: With the QUA-DIT project we seek to identify disease-specific areas of in-hospital management where diagnostic and/or therapeutic guideline-adherence is poor. Furthermore, we plan to investigate the effect of guideline-adherence on patient outcome related quality indicators. By establishing a sustainable quality control program addressing these areas, we intend to lay the foundation for the overall improvement of hospital care.
Methods: The QUA-DIT project consists of seven clinically driven audits in typical acute diagnoses in the department of internal medicine at the Cantonal Hospital Baselland. Recent clinical routine data concerning diagnostic workup, treatment, and other measures of care will be collected and descriptively compared to the established national and international disease-specific guidelines. Ultimately, association of guideline-adherence with quality indicators mortality, length of hospital stay, and rehospitalization will be assessed by multivariable regression models. We expect to include data of 2410 patients into our analyses.
Relevance: Establishing a series of clinical audits with the same methodology and the aim to improve quality in different fields of internal medicine is an innovative approach. Based on the audit findings, we plan to implement several measures to achieve improvement in the evidence-based management of our patients. Being transparent about the results with the intention of publication is a way of creating awareness in the internal medicine community and may serve as a motivation for other hospitals to follow the example. The QUA-DIT project represents a significant step for improvement of the overall healthcare system, and ultimately for the health of the population.
Publications
Lüthi-Corridori, Giorgia et al. (2024) ‘Diagnosis and Therapy of Community-Acquired Pneumonia in the Emergency Department: A Retrospective Observational Study and Medical Audit’, Journal of Clinical Medicine, 13. Available at: https://doi.org/10.3390/jcm13020574.
Boesing, Maria et al. (2023) ‘The Management of Acute Exacerbations in COPD: A Retrospective Observational Study and Clinical Audit’, Journal of Clinical Medicine, 13(1), p. 19. Available at: https://doi.org/10.3390/jcm13010019.
Isaak J et al. (2023) ‘Diagnostic Workup and Outcome in Patients with Profound Hyponatremia.’, Journal of clinical medicine, 12(10). Available at: https://doi.org/10.3390/jcm12103567.
Mbata, Munachimso Kizito et al. (2023) ‘The Correct Indication to Induce Labour in a Swiss Cantonal Hospital’, Journal of Clinical Medicine, 12. Available at: https://doi.org/10.3390/jcm12206515.
Schnyder D et al. (2023) ‘Audit of Asthma Exacerbation Management in a Swiss General Hospital.’, Respiration; international review of thoracic diseases, 102(1), pp. 12–24. Available at: https://doi.org/10.1159/000527268.
Members (3)
Jörg Leuppi
Research group leader
Maria Bösing
Project leader