Desarrollo y estudio piloto de un conjunto esencial de indicadores para los servicios de cirugía general

Soria-Aledo, Víctor; Angel-Garcia, Daniel; Martínez-Nicolás, Ismael; Cladera, Pere Rebasa; Sánchez, Roger Cabezali; García, Luis Francisco Pereira

doi:10.1016/j.ciresp.2016.06.009

Cited by 5 publications

(9 citation statements)

References 29 publications

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“…The post-surgical mortality indicator is among the indicators proposed by the Lancet Commission 23 to assess surgical care. A similar study 16 developed for the Spanish health system also pointed out the indicators: “Post-surgical readmission”, “Prophylaxis of venous thromboembolism”, “Adequate antibiotic prophylaxis” and “Surgical site infection” as valid indicators to assess surgical quality; however, these indicators are directed only to surgeries of the digestive tract.…”

Section: Discussionmentioning

confidence: 95%

“…Benchmarking has been used to seek opportunities for improvement and make comparisons of similar organizations 16 , 24 . It has been listed as a strategy by the World Health Organization (WHO) in the Global Action Plan for Patient Safety 2021-2030 22 , and the development of “good” indicators is a success factor for benchmarking actions 25 .…”

Section: Discussionmentioning

confidence: 99%

“…The review of existing literature and consensus methods are increasingly used and recommended by the scientific community for this type of study 16 , 30 . The use of the RAND/UCLA method to establish consensus, through the use of remote communication resources ( internet ), allowed to bring together qualified specialists from various regions of the country.…”

Section: Discussionmentioning

confidence: 99%

“…A questionnaire was developed using the Google Forms platform, based on similar studies 12 , 14 , 16 , containing five closed questions for each indicator, using a Likert-type scale for responses. The following criteria were used for the evaluation and selection of indicators: 1) Is the indicator clearly relevant?…”

Section: Methodsmentioning

confidence: 99%

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Validação de indicadores de qualidade do cuidado cirúrgico no Sistema Único de Saúde

et al. 2023

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OBJETIVO: Validar um conjunto de indicadores para monitoramento da qualidade dos procedimentos cirúrgicos no Sistema Único de Saúde (SUS). MÉTODOS: Estudo de validação desenvolvido em 5 etapas: 1) revisão de literatura; 2) priorização de indicadores; 3) validação de conteúdo dos indicadores por método de consenso RAND/UCLA; 4) estudo piloto para análise da confiabilidade; e 5) desenvolvimento de instrutivo para tabulação dos indicadores de resultado para monitoramento via sistemas de informações oficiais. RESULTADOS: A partir da revisão de literatura, foram identificados 217 indicadores de qualidade cirúrgica. Os indicadores excluídos foram: indicadores baseados em evidências científicas inferiores a 1A, similares, específicos, que correspondiam a eventos sentinelas; e aqueles que não se aplicavam ao contexto do SUS. Foram submetidos ao consenso de especialistas 26 indicadores com alto nível de evidência científica. Foram validados 22 indicadores, dos quais 14 indicadores de processo e 8 indicadores de resultado com índice de validação de conteúdo ≥80%. Dos indicadores de processo validados, 6 foram considerados confiáveis substancialmente (Coeficiente de Kappa entre 0,6 e 0,8; p < 0,05) e 2 tiveram confiabilidade quase perfeita (coeficiente de Kappa > 0,8, p < 0,05), quando analisada a concordância interavaliador. Foi possível mensurar e estabelecer mecanismo de tabulação para TabWin para 7 indicadores de resultado. CONCLUSÃO: O estudo contribui com o desenvolvimento de um conjunto de indicadores cirúrgicos potencialmente eficazes para o monitoramento da qualidade do cuidado e segurança do paciente nos serviços hospitalares do SUS.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Validação de indicadores de qualidade do cuidado cirúrgico no Sistema Único de Saúde

et al. 2023

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“…Para la descripción de los indicadores se utilizó un formato de ficha técnica estandarizado 29 utilizado en estudios anteriores 30,31 para favorecer la obtención homogénea de información de estos indicadores. Los datos se colectaron mediante aplicaciones móviles.…”

Section: Desarrollo De Fichas Técnicas E Instrumentos De Recolección unclassified

Indicadores de calidad de la atención a neonatos con patologías seleccionadas: estudio piloto

et al. 2018

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Objetivo. Desarrollar y pilotar indicadores de calidad de la atención a neonatos con padecimientos relevantes en México (prematuridad, sepsis neonatal, asfixia perinatal e hipoxia intrauterina). Material y métodos. Se construyeron indicadores propios a partir de recomendaciones clave de las guías de práctica clínica nacionales e indicadores encontrados en repositorios internacionales. Previa búsqueda, selección y priorización, los indicadores fueron pilotados en dos hospitales. Se analizó la factibilidad de medición, fiabilidad (índice kappa) y utilidad para detectar problemas de calidad. Resultados. Se seleccionaron y pilotaron 23 indicadores; 12 eran compuestos. Del total, nueve fueron factibles y fiables. La calidad de la información en los hospitales fue diversa y frecuentemente deficiente, limitando tanto la factibilidad como la fiabilidad de los indicadores. Los niveles de cumplimiento identificaron oportunidades de mejora. Conclusiones. Se propone un set de nueve indicadores válidos, factibles, fiables y útiles para la monitorización de la calidad en la atención a neonatos patológicos.

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Risk-adjustment models for clean and colorectal surgery surgical site infection for the Spanish health system

García

Nicolás

Marín

et al. 2020

International Journal for Quality in Health Care

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Objective To develop risk-adjusted models for two quality indicators addressing surgical site infection (SSI) in clean and colorectal surgery, to be used for benchmarking and quality improvement in the Spanish National Health System. Study Design A literature review was undertaken to identify candidate adjustment variables. The candidate variables were revised by clinical experts to confirm their clinical relevance to SSI; experts also offered additional candidate variables that were not identified in the literature review. Two risk-adjustment models were developed using multiple logistic regression thus allowing calculation of the adjusted indicator rates. Data Source The two SSI indicators, with their corresponding risk-adjustment models, were calculated from administrative databases obtained from nine public hospitals. A dataset was obtained from a ten-year period (2006 to 2015) and it included data from 21,571 clean surgery patients and 6,325 colorectal surgery patients. Analysis methods Risk-adjustment regression models were constructed using Spanish National Health System data. Models were analysed so as to prevent overfitting, then tested for calibration and discrimination, and finally bootstrapped. Results Ten adjustment variables were identified for clean surgery SSI, and 23 for colorectal surgery SSI. The final adjustment models showed fair calibration (Hosmer-Lemeshow: clean surgery chi2=6.56, p=0.58; colorectal surgery chi2=6.69, p=0.57) and discrimination (area under ROC curve: clean surgery 0.72, CI 95% 0.67-0.77; colorectal surgery 0.62, C.I.95% 0.60-0.65). Conclusions The proposed risk-adjustment models can be used to explain patient-based differences among healthcare providers. They can be used to adjust the two proposed SSI indicators.

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Desarrollo y estudio piloto de un conjunto esencial de indicadores para los servicios de cirugía general

Cited by 5 publications

References 29 publications

Validação de indicadores de qualidade do cuidado cirúrgico no Sistema Único de Saúde

Validação de indicadores de qualidade do cuidado cirúrgico no Sistema Único de Saúde

Indicadores de calidad de la atención a neonatos con patologías seleccionadas: estudio piloto

Risk-adjustment models for clean and colorectal surgery surgical site infection for the Spanish health system

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