Measuring Quality

IQM member hospitals have agreed on common quality targets. If a target value is not achieved, this may indicate possible quality problems in treatment procedures and structures. Statistical deviations from target values are therefore used as the triggering criterion for peer reviews.

During a peer review, the actual treatment procedures and structures used in the hospital are analysed to identify areas for improvement. The results are used to derive measures to improve quality.

Quality Indicators: Identifying Potential for Improvement

IQM member hospitals use quality indicators that are calculated from routine data. The Inpatient Quality Indicators (IQI) are determined from hospital billing data (data records according to Section 21 KHEntgG in Germany and Federal Statistical Office (BfS) requirements in Switzerland) and the medical documentation data (ICD-10, OPS) contained therein.


Country-specific versions are available for Germany (G-IQI), Switzerland (CH-IQI) and Austria (A-IQI). IQM uses the G-IQIs and CH-IQIs to map a hospital’s performance for different diseases. The version, 5.4, includes more than 500 outcome-based, volume-based and procedure-based indicators for more than 65 major disease syndromes and treatments.


Advancing the Indicators

Quality management that strives for consistent improvement in the quality of medical outcomes and treatments requires an honest accounting of one’s own strengths and weaknesses. This can only be achieved with quality measurements that are reliable, meaningful and focused on outcomes.


The “G-IQI Development” working group is tasked with the continuous improvement of the G-IQIs/CH-IQIs in cooperation with IQM members, professional associations and the Swiss Federal Office of Public Health. A form for submitting suggested improvements or new quality indicators can be found in the members area.


Measuring Quality Based on Routine Data

Under the diagnosis-related group (DRG) system, every service in the hospital is coded by case and mapped according to diagnoses and procedures (ICD and OPS codes). Measuring quality with indicators based on routine data is very efficient (no additional documentation required in the hospitals) and objective (easy to verify). The results enable the hospital to identify areas for improvement.


In addition to the G-IQIs, IQM hospitals in Germany also evaluate the Patient Safety Indicators (PSI). Based on the indicators from the Agency for Healthcare Research and Quality (AHRQ) in the United States, these indicators are calculated in cooperation with the Hochschule Niederrhein University of Applied Sciences.


Cross-Sector Quality Measurement (QSR)

QSR stands for the German phrase for quality assurance with routine data. IQM partners with the AOK Research Institute (WIdO) to perform the cross-sector quality measurement. The main advantage of QSR compared to other quality measurement methods is that events following a hospital stay are also included in the measurement (e.g. unplanned follow-up operations for hip and knee replacement or surgical complications within a certain period of time). QSR results are displayed in the AOK Health Navigator for public reporting on the quality of German hospitals.