Development of Quality Indicators of Stroke Centers and Feasibility of Their Measurement Using a Nationwide Insurance Claims Database in Japan　― J-ASPECT Study ―

Indicadores de calidad para unidades de cuidados intensivos respiratorios

“…En años recientes la aparición de grupos colaborativos ha derivado en la propuesta de indicadores de calidad para grupos específicos de pacientes de las distintas ramas de atención de la medicina crítica que se adapten cada vez más a sus necesidades. [11][12][13][14][15] Parte del trabajo colaborativo de este grupo consistió en identificar aspectos relevantes de las UCIRs, priorizarlos y construir indicadores reuniendo a un grupo de expertos y con el apoyo logístico de instituciones dedicadas a la medicina respiratoria y del paciente crítico como son el COMMEC y el Consejo Nacional de Neumología en México. En las sesiones de trabajo se eligieron, por consenso, aquellos indicadores que reunían condiciones de validez (incluyendo su validez aparente), sensibilidad y especificidad.…”

Measuring Quality of Care for Ischemic Stroke Treated With Acute Reperfusion Therapy in Japan ― The Close The Gap-Stroke ―

“…The result was the development of 17 measures representing QIs for PSCs and 12 for CSCs (Supplementary Table 1). 9 Because the DPC database lacks critical information to monitor the Patients with any type of stroke (I60.1-9*, I61.0-9*, I63.0-9*) or TIA (G45.0-9*) PSC1,3,5, 13,14,15,17 IV rt-PA performed PSC6, CSC3…”

“…The CTGS QI Measurement Tool was developed to facili-for advanced stroke care (Supplementary Table 1). 9 The QIs relevant to AIS and transient ischemic attack (TIA) were selected in this study. The selected PSC QIs comprised: documentation of initial severity measure (PSC 1), diagnosis (PSC 2-4), coordination of care (PSC 5), acute medication (PSC 6-8), initiation of secondary prevention (PSC 9-12), prevention of complications (PSC 13,14), rehabilitation (PSC 15), and patient education (PSC 16,17).…”

Towards Further Development of a Quality Improvement System for Stroke Practice in Japan

“…1 Importantly, improved adherence was sustained in participating hospitals regardless of bed capacity, geography, and teaching status over 4 years. Similar programs or systems have also been established in other countries, as summarized by Nishimura et al 2 The establishment of primary stroke centers (PSCs) and comprehensive stroke centers (CSCs) was recommended worldwide in the early 2000s. 3,4 However, certification of PSCs has only just started recently in Japan, and that of CSCs has not yet been initiated.…”

“…2 Because the DPC database lacked data about time (onset, arrival, or imaging), the National Institutes of Health Stroke Scale (NIHSS) score, and blood test values, Nishimura et al were only able to calculate 6 of the 29 developed QIs in their study (Figure). 2 In this issue of the Journal, Ren et al reported a novel strategy to overcome this limitation. 7 These authors developed the CTGS QI Measurement Tool to facilitate…”