Developing a National Continuous Quality Improvement System for Neuromodulation Treatment in the Netherlands

Quality based social insurance coverage and payment of the application of a high cost medical therapy: the case of spinal cord stimulation for chronic non-oncologic pain in The Netherlands

“…The projection of the ISO definition on a clinical care process (SCS) resulted in elements of the national CQI system for SCS [23]. With the development of these elements, a restricted group of centers, a standardized treatment protocol, a national database, feedback meetings on a regular base and outcome indicators, the DNG was found to be able to monitor and improve the quality of SCS for chronic non-oncologic pain relief.…”

“…In the future the DNG will be able, using the performance indicators, to monitor continuously the treatment outcome per treatment indication and per participating centre. The DNG showed that they were capable of self-regulation through datadriven protocol adjustments and changes in treatment indications [23].…”

“…To operationalize this definition a step-wise, incremental bottom-up approach was followed [23]. In the first three months of 1999 meetings were organized during which the DNG deliberated on a standard treatment protocol.…”

The Development of a Quality System for Neuromodulation in the Netherlands

“…The WGN met during the period between 1999 and 2002 on a regular basis, and at all times the project group of the Erasmus University Rotterdam was present (8,11). The project group and the meetings were chaired by an independent chairperson.…”

Long-Term Outcomes of Continuous Intrathecal Baclofen Infusion for Treatment of Spasticity: A Prospective Multicenter Follow-Up Study

“…In 1998, the Dutch government decided to include ITB in the social health insurance system as long as uniformity of the treatment and continuous improvement based on outcomes could be guaranteed in a limited number of treatment centers. Eight ITB treatment centers (Dutch Neuromodulation Group, Section Spasticity) developed a national continuous quality improvement (CQI) system for ITB in close cooperation with a support team from the Erasmus University Rotterdam (5). During the formalization of the national CQI system, the eight centers followed a standardized treatment protocol and outcome measures were collected in a national database.…”