Current practice guideline program in the Netherlands
NKO has a board (in which the 3 founding parties were represented), an
agenda council (for advising the board on substantive programming) and
an implementation council (for advising the board on implementation
issues).
NKO financed the development of all practice guidelines: each standard
had a contractor, often a third party for project management. Practice
guidelines are developed involving stakeholders who contribute through
participation in a working group, consultation and authorization.
Stakeholders include patients and their relatives, professionals, but
also representatives of healthcare providers and financers. Each
standard had a development phase (1.5 years on average), a consultation
phase (3 months on average) and an authorization phase (also 3 months on
average).
Between 2014 and 2018 NKO developed over 40 practice guidelines
(standards of care (table 1) and generic standards (table 2) for Dutch
mental health care. Development and structure of the practice guidelines
was identical and all standards were edited and legally checked. In June
2019 a large number of practice guidelines were included in the Register
of the Healthcare Institute of the Netherlands. This is an important
milestone because in the Netherlands this Register is the central place
for information about quality of care*11* The registration of a
quality standard or measuring instrument in the Register does not
change the responsibilities of a healthcare provider vis-à-vis a
client. Whether or not a quality standard or measuring instrument has
been drawn up with perseverance from the Healthcare Institute, or
whether it is included in the Register, has no legal consequences for
the legal relationship between the care provider and the client. The
Healthcare Inspection can use the registered quality standards as a
basis for monitoring and maintaining the quality of care provision.
The Healthcare Inspection thus has a growing set of field standards
for quality of care. The Healthcare Inspection involves both field
standards from the Register and field standards that are not (yet)
registered in the Register in its supervision..