When the indicator groups have determined the standards, indicators and prognostic factors the project is implemented in all public hospital units in Denmark. This has required the development of an organisation at unit, hospital and regional level to ensure that the collection of data becomes complete, and to ensure that the data collected are reproducible corresponding with the definitions determined by the indicator groups. At the same time the unit level has a central role in the validation and interpretation of data. It is essential for the success of the project that the implementation is incorporated into the daily work of the units and that the structure of the project follows the daily structure in leadership and consultancy which is already incorporated in the regions. It is important that the data collection is done as a part of the daily clinical work.

Implementation conferences have been carried out by the NIP-secretariat in every region make sure that all hospitals and units are informed and capable of collecting, validating and receiving data for the project.

The implementation in the regions requires an establishment of a close co-operation between the organisation of the project, the units and the regions both regarding the process of data collection and regarding the interpretation of the data. To optimise this co-operation a testing of logistics and organisation has taken place in 3-4 test regions.

In relation to support the implementation in the regions an implementation manual has been published.


Perspectives:

The Danish National Indicator Project aims to document and develop the quality in health care concerning the disease specific areas. The project aims to assess the health care system as an organisation and not focus on individuals. It is not the aim of the project to find scape goats but to bring forth the best possible basis for improvement of quality and development of quality in the health care system. At the same time a qualified basis will be created for a dialouge between the health care providers, the leaders, the political system and the patients on the base of evidence based documentation.

There are two important criterias for the success of the project. The first is that all involved providers in the health care system must take responsibility for the development and accept the implementation of the project. The second is that the regions are active in the project both regarding the economical framework, prioritising and also contribute to practical back-up, as the project is implemented locally.

For the health care providers the benefit of the project is that they get the possibility to see a qualified comparison of the quality in the units over time. It is possible to show how the quality develops over time in each unit in relation to the involved diseases. Equally the un-going monitoring of the quality gives an opportunity to improve quality by looking at results over time and follow the effect of structural changes and changes in ressouces etc.

The surveillance and documentation for the present aight involved diseases are set to spread over three years. Here after the whole project will be evaluated to find out whether or not the project should become a permanent part of the Danish health care system.