Assessing the Quality of Psychiatric Hospital Care: A German Approach

OBJECTIVE: The German Ministry of Health commissioned a nonprofit organization to develop a tool for assessing the quality of psychiatric hospital care. METHODS: The authors were members of an expert group established to develop an assessment tool that could be used by professional caregivers, patients, patients' relatives, managers, purchasers, and mental health care planners. RESULTS: A three-dimensional model was developed in which 23 quality standards may be applied to 28 areas of practice. For each application, questions can be asked at four levels to stimulate ongoing quality management: the individual treatment process, the individual outcome, the treatment unit, and the hospital as a whole. The authors provide sample questions to illustrate the approach. CONCLUSIONS: The approach to quality assessment embodied in the model is comprehensive and addresses ethical issues, but it is also complicated and difficult to handle. Unlike models developed in the United States, it is not intended to be objective or standardized, and it does not yield a score. To some extent, the model's approach to assessment may reflect German cultural values and traditions.