The Swiss national association for quality development in hospitals and clinics ANQ aims at the coordination and introduction of measures for quality improvement at the national level in Switzerland, particularly the uniform insbesondere die einheitliche implementation of measurements of outcomes quality. The national quality measurements in psychiatric hospitals have started on July 1, 2012. The provisions for the measurements apply to inpatient psychiatry and include all patients except those in child and youth psychiatry.

Commissioned by the ANQ, a working group at the Psychiatric University Clinics (UPK) Basel develops the concept for the data collection and analysis for the benchmarking of important outcome parameters (external and self-assessment of symptom charge, measures limiting freedom) and the medical statistics. In addition, we counsel the about 120 participating hospitals and departments in their data management. From 2014 on the study is extended to children and adolescent as well as forensic psychiatry.

Duration: January 1, 2012 – Sept 30, 2017

Funding: National association for quality development in hospitals and clinics ANQ

Lead: Bernhard Bührlen at UPK Basel

Weblink: Website ANQ

Inventory of the treatment situation before and while obtaining an invalidity pension. Feasibility study (BSV-Nr. C11_05)

About every sixth citizen of Switzerland suffers from a clinically relevant mental disorder. Compared to that few patients are seen by psychiatric caretakers. A possible undersupply with psychiatric-psychotherapeutic treatments could among others be a reason for the fact that mental disorders have become the most frequent cause of pensions because of invalidity. In order to obtain an optimal state of health in the population and to avoid as many invalidity-caused premature pensions as possible, improving the psychiatric-psychotherapeutic care has become a focus of the invalidity pension insurance (IV). The quality of care of insured persons should therefore be analysed more closely. However it was unclear how much of the necessary information could be found in the dossiers of the invalidity insurance.

By order of the Swiss Federal Social Insurance Office (FSIO) it was analysed in the form of a feasibility study which information regarding the treatment biography can be found in and analysed systematically from the IV dossiers. After a conceptional starting phase, in which a plan for drawing a reliable sample of dossiers as well as the instruments for the data collection were developed, the data were collected in two steps: In a briefer "quick coding" 120 IV dossiers were primarily analysed regarding which relevant characteristics of the health status, treatments etc. were documented at all. These data were analysed quantitatively. Twelve of these dossiers were then coded in more detail and not only the existence but also the content of the indicators was recorded. This comprehensive characterisation of the dossiers was used for a qualitative data analysis.

Duration: 01 July 2012 – 30 April 2013

Funding: Swiss Federal Social Insurance Office

Coordination: Peter Rüesch (ZHAW); Bernhard Bührlen (UPKBS)

Weblink: Download report

German policy-making has undertaken important steps to strengthen clinical research in Germany. However, the industry continues to complain about disadvantages in the competition with other countries. Although the number of clinical studies has been rising during the last years, this increase has been significantly bigger in some competing countries. In the long run this could impact on employment and supply of patients with innovative pharmaceuticals, as new products are introduced preferredly in those countries in which the clinical trials had taken place.

In addition, the traditional procedures of clinical research are questioned by new, mostly biotechnological therapy methods, e.g. gene or cell therapies or monoclonal anti-bodies, or by nano medicine, for which the existing evidence is still relatively weak and which therefore can hold particular risks for patients and study participants. For these new procedures, scientific development forges ahead at quick pace, so that the framework conditions in particular for the protection of the participants in clinical trials have to be re-assessed and adopted to new challenges frequently, but without hampering the carrying-out of clinical studies in Germany too much.

Aims of the project were the description and assessment of the various conditions of Germany as research location for clinical trials and an in-depth analysis for the area of biomedical innovations.

Duration: May 2007 – June 2009

Funding: Office for Technology Assessment at the German Federal Parliament (TAB)

Project lead: Bernhard Bührlen at Fraunhofer ISI

Weblink: Website of the study at TAB

Clinical research is of paramount relevance for the development of new pharmaceuticals and other medical treatments as well as for securing and optimisation of their application in routine practice. All clinical studies are regulated by the German pharmaceuticals law (Arzneimittelgesetz, AMG), insofar as they assess the efficacy, safety or metabolisation of pharmaceuticals with the aim to test their safety of efficacy. This type of clinical studies is called "clinical trial" ("klinische Prüfung").

To describe and assess the initial situation, data on the frequency of non-commercial studies in Germany as well as on their goals and financing were collected in a written survey. The actual discurse was analysed empirically for completeness from the perspectives of all relevant stakeholder groups and its agenda was supplemented by issues that had been neglected earlier. The practical relevance of single factors was evaluated on the basis of the survey data as well as of expert interviews and the results of a stakeholder workshop. The final report describes and assesses the manifold factors which exert influence on a powerful non-commercial clinical research in Germany and makes suggestions for the further optimisation of its framework conditions including a priorisation of the most important options for action.

Duration: Oct. 2008 – March 2010

Funding: Office for Technology Assessment at the German Federal Parliament (TAB)

Project lead: Bernhard Bührlen at Fraunhofer ISI

Weblink: Website of the study at the TAB