Quality Indicators · Dr Suleman Aktaa. Specialty Trainee in Cardiology. Clinical Research Fellow....
Transcript of Quality Indicators · Dr Suleman Aktaa. Specialty Trainee in Cardiology. Clinical Research Fellow....
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Dr Suleman AktaaSpecialty Trainee in CardiologyClinical Research FellowLeeds, UK
Quality Indicators
27 January 2020
#EORP@SulAktaa
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• None
Declaration of Interest
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The degree to which services increase the likelihood of desired outcomesand are consistent with current knowledge
Quality of Care
Lohr KN (ed.). National Academy Press, 1990
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Quality of Care
Safety
EBM
Patient-centeredness
Timeliness of care
Equity
Efficiency
National Academies Press 2001
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Framework to measure components of the quality of health care
Quality Indicators
Spertus JA, et al. Circulation. 2005;111:1703–12
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Quality Indicator
Scientifically acceptable
Useable
Feasible (measurable)
Important
National Quality Forum
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• Why to measure quality of care
• How to measure quality of care
• Challenges to overcome
Objectives
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• Why to measure quality of care
• How to measure quality of care
• Where can we do better
Measure to Improve
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T B Dondo et al. BMJ Open 2016;6:e011600
TR: 0.44, 95% CI: 0.41–0.45
Dondo T, et al. Eur Heart J Acute Cardiovasc Care. 2017;6:412–420
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Jernberg T, et al. JAMA. 2011; 305: 1677-1684
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N Engl J Med 2018; 379:948-957
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Measure to improve
Quality of Care measurement
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• Why to measure quality of care
• How to measure quality of care
• Where can we do better
Quality Indicators
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Schiele F, Gale CP, et al. Eur Heart J Acute Cardiovasc Care. 2017 Feb; 6(1):34-59
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Bebb O, et al. Eur Heart J. 2017;38(13):974–982.
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Bebb O, et al. Eur Heart J. 2017;38(13):974–982.
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QIs Development
Phase 1Identify domains and
dimension of care
Phase 2Literature & CPGs
Review
Phase 3Modified Delphi process
(patient involvement)
Phase 4External validation &
feasibility study
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Modified from MacLean, et al. N Engl J Med 2018 378:1757-1761
QI selection
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Modified Delphi Process
Inclusion Disagreement Exclusion
Normand SL, et al. Int J Qual Health Care 1998;10:247–260
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QIs & OMs for AF
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PROJECTSTART
JUN JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN
Q1Systematic ReviewGuideline Review
Q2Consensus on QI/OM
(Delphi process)
Q3Manuscript Preparation
Q4Manuscript Review
and Submission
July, 18th
Working Group Launch
August, 30th
Common searchstrategy defined
September, 30th
Systematic review– QI-OM list
October, 31st
2-3 rounds of Delphi
November, 30th
QI & OM definedCase-mix definition
Manuscript Development
Early January1st Draft circulated
Document readyfor externalreview process
Feedback fromexternalreviewers
2nd Review submitted to Journal
Final submission to Journal
EP Journal Acceptance
QIs & OMs for AF
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Quality Indicators
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Measure to improve
Quality Indicators
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• Why to measure quality of care
• How to measure quality of care
• Where can we do better
Quality Indicators
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ESC Guidelines
Fanaroff A, et al. JAMA. 2019;321(11):1069-1080
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House of Care.
Maren Batalden et al. BMJ Qual Saf 2016;25:509-517
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Maren Batalden et al. BMJ Qual Saf 2016;25:509-517
“What is the matter with you?”
“What matters to you?”
Engaging Patients
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Bhatt DL, et al. JACC. 2015;66(20):2230–45
QIs and Registries
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Clinical Research
CPG
QIs recommended
Clinical Practice
QIs measured
EORP
Modified from Califf R, et al. J Am Coll Cardiol. 2002;40:1895–901
Feedback
Education
Collaboration Outcomes
Patient involvement