Improvement of Hospital Care for Patients With Non-Hodgkin's Lymphoma
In a previous study among 22 Dutch hospitals many gaps in the care for patients with
non-Hodgkin's lymphomas (NHL) were found, compared to best evidence as described in
guidelines. In a problem analysis study, barriers and facilitators for good quality of
NHL-care were assessed and a tailored implementation strategy was developed, based on these
findings. The proposed study aims at the effectiveness, feasibility and costs of this
tailored strategy to improve quality of care for patients with an NHL in a clustered
randomized controlled trial in 19 Dutch hospitals.
Multilevel regression analyses will be performed to evaluate the effectiveness of both
strategies. Exposure to and experiences with the strategy elements will be analysed
Regarding the costs, the two strategies are compared with a health care perspective. The
input of resources will be assessed by collecting volumes of consumed resources and
multiplying these by the price of each resource unit; the implementation process and
consequently costs will be estimated by an Activity Based Costing (ABC) approach. The output
will be determined by the level of adherence to the NHL quality indicators.
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
Change from baseline in adherence to quality indicators for NHL care
The effect of our interventions will be measured by means of adherence to quality indicators for optimal NHL care. The effects of the audit and feedback strategy (9 hospitals) versus the tailored strategy (9 hospitals) will be evaluated using previously developed quality indicators. These indicators for optimal NHL care were developed on the basis of evidence based guidelines, literature and opinions of clinicians about NHL care in a previous study and were validated.
baseline and 1 year
Rosella Hermens, PhD
Radboud University Nijmegen Medical Center
Netherlands: The Central Committee on Research Involving Human Subjects (CCMO)