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.