Quality and safety of care: the role of indicators

Braspenning, Jozé; Hermens, Rosella; Calsbeek, Hilly; Westert, Gert P.; Campbell, Stephen; Grol, Richard

doi:10.1002/9781118525975.ch7

Cited by 19 publications

(19 citation statements)

References 61 publications

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“…First, the indicators can be used to measure the current performance of geriatric co-management programmes and identify areas for improvement. 65 Second, the indicators can be used to start a new geriatric co-management programme. The structure and process indicators can be considered good geriatric care for frail patients.…”

Section: Discussionmentioning

confidence: 99%

Quality indicators for in-hospital geriatric co-management programmes: a systematic literature review and international Delphi study

et al. 2018

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ObjectiveTo find consensus on appropriate and feasible structure, process and outcome indicators for the evaluation of in-hospital geriatric co-management programmes.DesignAn international two-round Delphi study based on a systematic literature review (searching databases, reference lists, prospective citations and trial registers).SettingWestern Europe and the USA.ParticipantsThirty-three people with at least 2 years of clinical experience in geriatric co-management were recruited. Twenty-eight experts (16 from the USA and 12 from Europe) participated in both Delphi rounds (85% response rate).MeasuresParticipants rated the indicators on a nine-point scale for their (1) appropriateness and (2) feasibility to use the indicator for the evaluation of geriatric co-management programmes. Indicators were considered appropriate and feasible based on a median score of seven or higher. Consensus was based on the level of agreement using the RAND/UCLA Appropriateness Method.ResultsIn the first round containing 37 indicators, there was consensus on 14 indicators. In the second round containing 44 indicators, there was consensus on 31 indicators (structure=8, process=7, outcome=16). Experts indicated that co-management should start within 24 hours of hospital admission using defined criteria for selecting appropriate patients. Programmes should focus on the prevention and management of geriatric syndromes and complications. Key areas for comprehensive geriatric assessment included cognition/delirium, functionality/mobility, falls, pain, medication and pressure ulcers. Key outcomes for evaluating the programme included length of stay, time to surgery and the incidence of complications.ConclusionThe indicators can be used to assess the performance of geriatric co-management programmes and identify areas for improvement. Furthermore, the indicators can be used to monitor the implementation and effect of these programmes.

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Section: Discussionmentioning

confidence: 99%

Quality indicators for in-hospital geriatric co-management programmes: a systematic literature review and international Delphi study

et al. 2018

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“…For process and outcome quality indicators that are measured by measurement instruments, those requirements include criteria of methodology and feasibility. 15 Methodological criteria are clinimetric properties, that is, content validity, construct validity, internal consistency, interobserver reliability, test-retest reliability, and sensitivity to change/responsiveness. 16 , 17 Feasibility/acceptability criteria include the level of implementation of procedures or the sustainability of treatment recommendations for the quality of care.…”

Section: Introductionmentioning

confidence: 99%

“… 16 , 17 Feasibility/acceptability criteria include the level of implementation of procedures or the sustainability of treatment recommendations for the quality of care. 15 …”

Section: Introductionmentioning

confidence: 99%

Quality Measurement Recommendations Relevant to Clinical Guidelines in Germany and the United Kingdom: (What) Can We Learn From Each Other?

Petzold

Deckert

Williamson

et al. 2018

INQUIRY

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We conducted a systematic review of clinical guidelines (CGs) to examine the methodological approaches of quality indicator derivation in CGs, the frequency of quality indicators to check CG recommendations in routine care, and clinimetric properties of quality indicators. We analyzed the publicly available CG databases of the Association of the Scientific Medical Societies in Germany (AWMF) and National Institute for Health and Care Excellence (NICE). Data on the methodology of subsequent quality indicator derivation, the content and definition of recommended quality indicators, and clinimetric properties of measurement instruments were extracted. In Germany, no explicit methodological guidance exists, but 3 different approaches are used. For NICE, a general approach is used for the derivation of quality indicators out of quality standards. Quality indicators were defined in 34 out of 87 CGs (39%) in Germany and for 58 out of 133 (43%) NICE CGs. Statements regarding measurement properties of instruments for quality indicator assessment were missing in German and NICE documents. Thirteen pairs of CGs (32%) have associated quality indicators. Thirty-four quality indicators refer to the same aspect of the quality of care, which corresponds to 27% of the German and 7% of NICE quality indicators. The development of a standardized and internationally accepted methodology for the derivation of quality indicators relevant to CGs is needed to measure and compare quality of care in health care systems.

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“…Our suggestion to use indicators for diagnostic purposes can from this perspective be described as a case of “back to the future”. The use of indicators is however most effective when integrated into a system of continuous monitoring and improvements [ 37 ]. In this respect there is also a need for improvements.…”

Section: Discussionmentioning

confidence: 99%

The use of outcome and process indicators to incentivize integrated care for frail older people: a case study of primary care services in Sweden

Anell¹,

Glenngård

2014

Int J Integr Care

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Quality and safety of care: the role of indicators

Cited by 19 publications

References 61 publications

Quality indicators for in-hospital geriatric co-management programmes: a systematic literature review and international Delphi study

Quality indicators for in-hospital geriatric co-management programmes: a systematic literature review and international Delphi study

Quality Measurement Recommendations Relevant to Clinical Guidelines in Germany and the United Kingdom: (What) Can We Learn From Each Other?

The use of outcome and process indicators to incentivize integrated care for frail older people: a case study of primary care services in Sweden

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