Quality Indicators for the Care of Chronic Obstructive Pulmonary Disease in Vulnerable Elders

Kleerup, Eric C.

doi:10.1111/j.1532-5415.2007.01332.x

Cited by 8 publications

(5 citation statements)

References 77 publications

(83 reference statements)

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Section: Discussionmentioning

confidence: 99%

“…Several studies have developed quality indicators for COPD care [ 39 – 44 ], but most sets were developed to evaluate processes or structures of care, e.g. monitoring the proportion of patients for whom smoking status or the availability of exercise equipment was recorded [ 39 , 41 – 44 ]. These studies differed in their care focus areas, which were hospitalised care, end-of-life care, transitional care after hospitalisation, pulmonary rehabilitation, vulnerable elders, or primary care in general [ 39 – 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…monitoring the proportion of patients for whom smoking status or the availability of exercise equipment was recorded [ 39 , 41 – 44 ]. These studies differed in their care focus areas, which were hospitalised care, end-of-life care, transitional care after hospitalisation, pulmonary rehabilitation, vulnerable elders, or primary care in general [ 39 – 44 ]. None of these publications performed a practice test.…”

Section: Discussionmentioning

confidence: 99%

“…(43)(44) These studies differed in their care focus areas, which were hospitalized care, end-of life care, transitional care after hospitalization, pulmonary rehabilitation, vulnerable elders, or primary care in general (39)(40)(41)(42)(44) None of these publications performed a practice test. In one indicator set, developed for pulmonary rehabilitation, some similar domains (physical capacity, strength, and health-related quality of life) and measures (6MWT) were described.…”

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confidence: 99%

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A practice test and selection of a core set of outcome-based quality indicators in Dutch primary care physical therapy for patients with COPD: a cohort study

Verburg¹,

Dulmen²,

Kiers

et al. 2022

ERJ Open Res

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AimTo estimate the comparability and discriminability of outcome-based quality indicators by performing a practice test in Dutch physical therapy primary care, and to select a core set of outcome-based quality indicators that are well-accepted by physical therapists based on their perceived added value as a quality improvement tool.MethodsFirst, a list of potential quality indicators was defined, followed by the determination of the comparability (case-mix adjusted multi-level analysis) and discriminability (intraclass correlation coefficient (ICC)). Second, focus group meetings were conducted with stakeholders (physical therapists and senior researchers) to select a core set of quality indicators.ResultsOverall, 229 physical therapists from 137 practices provided 2651 treatment episodes. Comparability: in 10 of the 11 case-mix adjusted models, the ICC increased compared with the intercept-only model. Discriminability: the ICC ranged between 0.01 and 0.34, with five of the 11 ICCs being >0.10. The majority of physical therapists in each focus group preferred the inclusion of seven quality indicators in the core set, including three process and four outcome indicators based upon the Six-Minute-Walk-Test (6MWT), the Clinical COPD Questionnaire (CCQ), and the determination of quadriceps strength using a hand-held dynamometer (HHD).ConclusionThis is the first study that describes the comparability and discriminability of the outcome-based quality indicators selected for patients with COPD treated in primary care physical therapy practices. Future research should focus on increasing data collection in daily practice and on the development of tangible methods to use as the core set of a quality improvement tool.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

A practice test and selection of a core set of outcome-based quality indicators in Dutch primary care physical therapy for patients with COPD: a cohort study

Verburg¹,

Dulmen²,

Kiers

et al. 2022

ERJ Open Res

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“…In this study, COPD care quality was measured by QI. The QI applied were derived from both current CPG recommendations as well as relevant publications [30][31][32][33][34][35][36][37][38][39][40]. CPG and relevant publications had been identified beforehand through a literature search within CPG-databases, namely the Guidelines International Network (G-I-N), the National Guideline Clearinghouse (NGC), the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN), on PubMed and Google Scholar, and by reference tracking.…”

Section: Selection Of Qimentioning

confidence: 99%

Clinical governance as professional self-reflection: A cross-sectional study assessing the quality of COPD care in German general practice

Heinmüller

Frank

Höfle

et al. 2019

Preprint

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BACKGROUND In the United Kingdom, a system of clinical governance (CG) which was introduced “top-down” by politics tries to ensure high quality health services. In general practice, the meeting of quality targets was linked to financial incentives causing several negative effects. In Germany CG is not established. We advocate a “bottom-up” CG for German general practice to avoid these negative effects. AIMS To test “bottom-up” CG within a network of general practices (GPN) using chronic obstructive pulmonary disease (COPD) as example disease. As a first step, we wanted to assess the current care quality of the GPN for COPD. Furthermore, feasibility of a care quality assessment through routine data from electronic health records (EHR) should be evaluated. METHODS A cross-sectional study was conducted. Quality indicators (QI) were developed according to COPD guidelines. COPD patients of the GPN ≥40 years were identified. For the determination of QI, data were retrieved from EHR. RESULTS In total, 2568 COPD patients were identified. Their mean age was 67 (SD±12) years, 49% were male. Thirty-five percent had a parallel diagnosis of asthma. There was no documentation of any spirometry for 54% of patients, 29% had a spirometry within the previous year. An influenza vaccination was administered to 37% within the preceding twelve months, 12% received a pneumococcal vaccination in the last six years. Smoking status was documented for 44% within the last year. Several QI were not assessable. CONCLUSION Care quality assessment by means of EHR data was challenging due to non-standardized documentation. Assessable QI indicated suboptimal COPD care. Our results confirm the need for CG in German general practice and better EHR softwares supporting CG through structured documentation and feedback for GPs. We are planning to proceed with “bottom-up” CG by introducing quality improvement measures within the GPN in answer to this study.

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Handgrip strength measurement as a predictor for successful dry powder inhaler treatment

Frohnhofen

Hagen

2011

Z Gerontol Geriat

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Quality Indicators for the Care of Chronic Obstructive Pulmonary Disease in Vulnerable Elders

Cited by 8 publications

References 77 publications

A practice test and selection of a core set of outcome-based quality indicators in Dutch primary care physical therapy for patients with COPD: a cohort study

A practice test and selection of a core set of outcome-based quality indicators in Dutch primary care physical therapy for patients with COPD: a cohort study

Clinical governance as professional self-reflection: A cross-sectional study assessing the quality of COPD care in German general practice

Handgrip strength measurement as a predictor for successful dry powder inhaler treatment

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