Development and use of guideline-derived quality indicators for community lymphoedema

BACKGROUND: Treatment of lymphoedema is complex and needs specific skills. There are no standards for the evaluation of quality of care.

OBJECTIVE: Development and application of indicators for the measurement of quality of care in lymphoedema.

METHODS: In a three-step process including a national Delphi expert consensus, quality indicators were derived from national and international guidelines. In a cross-sectional study involving a large spectrum of care providers, the quality of lymphoedema care in the community was assessed by transforming the indicators to one unweighted quality index (QI).

RESULTS: A total of 12 quality indicators were identified and applied to n = 348 patients with lymphoedema and lipolymphoedema of any origin in the metropolitan area of Hamburg (90.8% female, mean age 57, SD 14.5 years). On average, 55% of the quality indicators were met, and 64.8% of the patients were satisfied with lymphoedema care. There was a significant correlation between QI and satisfaction.

CONCLUSIONS: The quality indicators and the QI are feasible and valid for the evaluation of quality of care. They can support optimizing lymphoedema care.