The Practicability of Swiss General Internal Medicine Quality Indicators in Hospital Inpatient Care
Authors: von Ahlen Christine , Moser Dominik , Schneider Dominik , Geissler Alexander 
Published: March 2023

Abstract
BACKGROUND: The quality transparency of medical care in Switzerland is underdeveloped in comparison to the range of healthcare services and utilisation of care. In order to strengthen the focus on quality, the Health Insurance Act (KVG) was revised and the Federal Quality Commission (EQK) was established. In the summer of 2021, the Swiss Society for General Internal Medicine (SGAIM) published six quality indicators for the inpatient sector, which support national efforts. The aim of these indicators is to facilitate a structured quality improvement process in internal medicine. There are currently no reference or comparative values for the SGAIM quality indicators. The present implementation study examines the practicability of the quality indicators recommended by the SGAIM in a hospital. It examines which quality indicators are helpful and supports the quality improvement cycle intended by the SGAIM.
METHODS: Using the QUALIFY assessment tool for quality indicators, the SGAIM indicators are structurally evaluated using the example of Hospital Männedorf (Canton of Zurich). Within this framework, a retrospective data analysis of the years 2020 and 2021 was carried out with 5,376 internal medicine patients, internal medicine assistants and management physicians (32 in 2020; 34 in 2021) as well as the CIRS reporting circle of internal medicine.
RESULTS: The examination of the methodological quality criteria for practicability according to the QUALIFY assessment instrument showed that many of the methodological quality criteria are fulfilled. However, the comprehensibility and interpretability for patients and the public are only given to a limited extent. The results of the SGAIM quality indicators in Hospital Männedorf were calculated according to the recommended evaluation intervals and were as such: A provisional discharge report within 24 hours was sent to the follow-up institution for an average of 23.7% of discharges. A new prescription of benzodiazepines in patients with an age of ≥65 years occurred in an average of 17.2% of patients per month. The fall history was collected from 100% of the patients. The monthly proportion of patients with transfusions with an Hb value of >8g/dl was 17.9% on average. The proportion of CIRS cases per patient averaged 1.3%. Hepatitis B vaccination protection was available to 100% of the staff in the medical service of internal medicine. Reference and comparative values for the classification of these results do not yet exist.
CONCLUSIONS: The quality indicators recommended by the SGAIM for the transmission of provisional discharge reports, new prescriptions for benzodiazepines and transfusions with Hb values >8 g/dl proved helpful. Development potential was shown for the following quality indicators: CIRS case processing, biography of falls in the last 12 months and hepatitis B vaccination protection. In the sense of national quality development in accordance with the KVG, it is desirable that the specialist society further develops its quality indicators and contributes them to the national quality efforts, which are coordinated by the EQK.