Research line:

Research evidence on the effectiveness of medical interventions is published in large quantities every year. This literature does not automatically lead to improvements in patient care. Unwarranted inter-doctor variation that has been documented since the 1940’s, continues to persist in many health care settings. Systematic implementation efforts are needed to achieve and sustain high quality of care.

Quality of health care, with regard to definition, measurement and improvement, is the central focus in this program. Clinical practice guidelines, including validated quality indicators, are seen as a strategy of first choice in this field. The development of guidelines is a challenge; in a consensus procedure evidence-based information regarding effectiveness, efficiency, patient preferences, and safety has to be appraised, and subsequently related to national or local experiences on best practices to assure feasibility, timeliness and equity. Research is therefore needed on the preferred methods for development of multidisciplinary guidelines and indicators, taking the different perspectives of the stakeholders, including the collective perspective of patients, into account.

It is well-known that just disseminating guidelines does not lead to significant improvements in quality of care. Therefore we also study determinants of variation in quality of care and of successful implementation strategies. Special attention is given to the interaction between professional and patient, when physicians may experience a conflict between the adherence to guidelines (with population-based recommendations) and patient-centred work (applying the guideline to a unique patient). Health care should be delivered according to accepted professional guidelines, but always taken context into account. Specific benchmarks for quality indicators may be set but these should be acceptable for all stakeholders. Health care delivery should also meet objective and subjective needs of individual patients towards the medical interventions and self-management.

Program objectives:

1. To study appropriate methods for development of clinical practice guidelines and indicators.

2. To develop training modules and performance indicators for shared decision making.

3. To study determinants of variation in the quality of professionals’ performance; these determinants may be related to the guidelines, the professionals, their colleagues, the patients, and the meso- and macro-organisation of health care.

4. To study the (cost) effectiveness of implementation strategies to improve quality of care.

Trudy van der Weijden has (co-)authored over 220 international scientific papers in peer reviewed journals, the total number of grants obtained adds up to more than 5 million Euro. She has successfully supervised 28 doctoral graduate students.

She is a member of the International Patient Decision Aids Standards Group (IPDAS) steering group, and the Guidelines International Network Patient and Public Involvement Group (GIN PUblic) steering group.

In 2011 she chaired the ISDM Conference in Maastricht. (International conference on Shared Decision Making)