Intrapartum care quality indicators: a systematic approach for achieving consensus

Background: Quality indicators can be used to identify gaps in care and drive frontline improvement activities. These efforts are important to prevent adverse events in the increasing number of ambulatory patients with advanced kidney disease in Canada, but it is unclear what indicators exist and the components of health care quality they measure. Objective: We sought to identify, categorize, and evaluate quality indicators currently in use across Canada for ambulatory patients with advanced kidney disease. Design: Environmental scan of quality indicators currently being collected by various organizations. Setting: We assembled a 16-member group from across Canada with expertise in nephrology and quality improvement. Patients: Our scan included indicators relevant to patients with chronic kidney disease in ambulatory care clinics. Measurements: We categorized the identified quality indicators using the Institute of Medicine and Donabedian frameworks. Methods: A 4-member panel used a modified Delphi process to evaluate the indicators found during the environmental scan using the American College of Physicians/Agency for Healthcare Research and Quality criteria. The ratings were then shared with the full panel for further comments and approval. Results: The environmental scan found 28 quality indicators across 7 provinces, with 8 (29%) rated as “necessary” to distinguish high-quality from poor-quality care. Of these 8 indicators, 3 were measured by more than 1 province (% of patients on a statin, number of patients receiving a preemptive transplant, and estimated glomerular filtration rate at dialysis start); no indicator was used by more than 2 provinces. None of the indicators rated as necessary measured timely or equitable care, nor did we identify any measures that assessed the setting in which care occurs (ie, structure measures). Limitations: Our list cannot be considered as an exhaustive list of available quality indicators at hand in Canada. Our work focused on quality indicators for nephrology providers and programs, and not indicators that can be applied across primary and specialty providers. We also focused on indicator constructs and not the detailed definitions or their application. Last, our panel does not represent the views of other important stakeholders. Conclusions: Our environmental scan provides a snapshot of the scope of quality indicators for ambulatory patients with advanced kidney disease in Canada. This catalog should inform indicator selection and the development of new indicators based on the identified gaps, as well as motivate increased pan-Canadian collaboration on quality measurement and improvement. Trial registration: Not applicable as this article is not a systematic review, nor does it report results of a health intervention on human participants.

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Quality indicators for all dimensions of infertility care quality: consensus between professionals and patients

Human Reproduction ◽

10.1093/humrep/det056 ◽

2013 ◽

Vol 28 (6) ◽

pp. 1584-1597 ◽

Cited By ~ 19

Author(s):

E. A. F. Dancet ◽

T. M. D'Hooghe ◽

C. Spiessens ◽

W. Sermeus ◽

D. De Neubourg ◽

...

Keyword(s):

Quality Indicators ◽

Care Quality

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Quality indicators of dental health care in Serbia

Stomatoloski glasnik Srbije ◽

10.2478/sdj-2019-0005 ◽

2019 ◽

Vol 66 (1) ◽

pp. 36-42

Author(s):

Svetlana Jovanović ◽

Maja Milošević ◽

Irena Aleksić-Hajduković ◽

Jelena Mandić

Keyword(s):

Health Care ◽

Quality Improvement ◽

Health System ◽

Quality Indicators ◽

Health Care Quality ◽

Care Quality ◽

System Quality ◽

Quality Health Care ◽

Quality Health

Summary Health care has witnessed considerable progresses toward quality improvement over the past two decades. More precisely, there have been global efforts aimed to improve this aspect of health care along with experts and decision-makers reaching the consensus that quality is one of the most significant dimensions and features of health system. Quality health care implies highly efficient resource use in order to meet patient’s needs in terms of prevention and treatment. Quality health care is provided in a safe way while meeting patients’ expectations and avoiding unnecessary losses. The mission of continuous improvement in quality of care is to achieve safe and reliable health care through mutual efforts of all the key supporters of health system to protect patients’ interests. A systematic approach to measuring the process of care through quality indicators (QIs) poses the greatest challenge to continuous quality improvement in health care. Quality indicators are quantitative indicators used for monitoring and evaluating quality of patient care and treatment, continuous professional development (CPD), maintaining waiting lists, patients and staff satisfaction, and patient safety.

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Nurses’ Perspectives About Reasons for Not Reporting Medical Errors in Educational Hospitals, Ahvaz, Iran

Health Technology Assessment in Action ◽

10.18502/htaa.v5i1.7380 ◽

2021 ◽

Author(s):

Zahra Rahsepar ◽

Farzad Faraji-Khiavi ◽

Mansour Zahiri ◽

Mohammadhosein Haghighizadeh

Keyword(s):

Medical Errors ◽

Health Care Quality ◽

Analytical Study ◽

Systematic Approach ◽

Care Quality ◽

Error Reporting ◽

Measurement Tool ◽

Work Experiences ◽

Process Factors ◽

Different Levels

Background: Reporting of medical errors is an approach to identify and prevent errors in hospitals. Objectives: The purpose of this study was to determine the barriers to error rError Reporting; Nurse; Hospital; Ahvazeport from the nurses’ viewpoints in Ahvaz Educational hospitals. Methods: This descriptive-analytical study was done on 206 nurses working in educational hospitals of Ahvaz selected by stratified random sampling. The measurement tool used in this study was a researcher-made questionnaire, which its validity was confirmed by content validity, and its reliability using Cronbach’s alpha was calculated to be 0.84. Data collection was performed from April to June 2019. Results: The causes of failure to error reporting included educational, attitudinal, process, structural, and managerial factors. The total mean score of the factors causing non-reporting of errors was 3.88 ± 0.53, which was between 3 and 4 (“important”). Also, educational, attitudinal, and process factors were reported as “very important” for nurses. Structural and managerial factors were rated reported “important” by nurses over 90% of nurses rated educational, attitudinal, and process factors as important and very important, and more than 70% of them rated structural and managerial factors as important and very important. Nurses with different levels of education or work experiences had different scores in reasons for not reporting errors. Conclusions: Some educational, attitudinal, process, structural, and managerial factors were critical reasons for not reporting errors. In order to reduce same errors in the future and promoting health care quality, officials need to develop strategies to remove barriers and consider the reasons for not reporting errors in nurses’ educational programs using team-based and forward-looking approaches, adopting an impersonal and systematic approach, and finally, modifying error reporting rules.

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Ten Years of Improving Acute Stroke Management in a Metropolitan Area: A Population-Based Quantification of Quality Indicators

European Neurology ◽

10.1159/000518428 ◽

2021 ◽

pp. 1-11

Author(s):

Anna Alegiani ◽

Michael Rosenkranz ◽

Leonie Schmitz ◽

Susanne Lezius ◽

Günter Seidel ◽

...

Keyword(s):

Acute Stroke ◽

Quality Indicators ◽

Metropolitan Area ◽

Stroke Care ◽

Care Quality ◽

Acute Stroke Care ◽

Stroke Units ◽

Stroke Treatment ◽

Acute Stroke Treatment ◽

Over Time

Background and Purpose: Rapid access to acute stroke treatment improves clinical outcomes in patients with ischemic stroke. We aimed to shorten the time to admission and to acute stroke treatment for patients with acute stroke in the Hamburg metropolitan area by collaborative multilevel measures involving all hospitals with stroke units, the Emergency Medical Services (EMS), and health-care authorities. Methods: In 2007, an area-wide stroke care quality project was initiated. The project included mandatory admission of all stroke patients in Hamburg exclusively to hospitals with stroke units, harmonized acute treatment algorithms among all hospitals, repeated training of the EMS staff, a multimedia educational campaign, and a mandatory stroke care quality monitoring system based on structured data assessment and quality indicators for procedural measures. We analyzed data of all patients with acute stroke who received inhospital treatment in the city of Hamburg during the evaluation period from the quality assurance database data and evaluated trends of key quality indicators over time. Results: From 2007 to 2016, a total of 83,395 patients with acute stroke were registered. During this period, the proportion of patients admitted within ≤3 h from symptom onset increased over time from 27.8% in 2007 to 35.2% in 2016 (p < 0.001). The proportion of patients who received rapid thrombolysis (within ≤30 min after admission) increased from 7.7 to 54.1% (p < 0.001). Conclusions: Collaborative stroke care quality projects are suitable and effective to improve acute stroke care.

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Applicability of care quality indicators for women with low-risk pregnancies planning hospital birth: a retrospective study of medical records

Scientific Reports ◽

10.1038/s41598-020-69346-8 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Kayo Ueda ◽

Toshiyuki Sado ◽

Yoshimitsu Takahashi ◽

Toshiko Igarashi ◽

Takeo Nakayama

Keyword(s):

Retrospective Study ◽

Quality Indicators ◽

Medical Records ◽

Care Quality ◽

Low Risk ◽

Hospital Birth

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Using quality indicators to predict inspection ratings: cross-sectional study of general practices in England

British Journal of General Practice ◽

10.3399/bjgp19x707141 ◽

2019 ◽

Vol 70 (690) ◽

pp. e55-e63 ◽

Cited By ~ 4

Author(s):

Thomas Allen ◽

Kieran Walshe ◽

Nathan Proudlove ◽

Matt Sutton

Keyword(s):

General Practice ◽

Quality Indicators ◽

Predictive Power ◽

Predictive Accuracy ◽

Cross Sectional Study ◽

Care Quality ◽

Sectional Study ◽

Validity And Reliability ◽

Cross Sectional ◽

Logistic Regression Models

BackgroundThe Care Quality Commission regulates, inspects, and rates general practice providers in England. Inspections are costly and infrequent, and are supplemented by a system of routine quality indicators, measuring patient satisfaction and the management of chronic conditions. These indicators can be used to prioritise or target inspections.AimTo determine whether this set of indicators can be used to predict the ratings awarded in subsequent inspections.Design and settingThis cross-sectional study was conducted using a dataset of 6860 general practice providers in England.MethodThe indicators and first-inspection ratings were used to build ordered logistic regression models to predict inspection outcomes on the four-level rating system (‘outstanding’, ‘good’, ‘requires improvement’, and ‘inadequate’) for domain ratings and the ‘overall’ rating. Predictive accuracy was assessed using the percentage of correct predictions and a measure of agreement (weighted κ).ResultsThe model correctly predicted 79.7% of the ‘overall’ practice ratings. However, 78.8% of all practices were rated ‘good’ on ‘overall’, and the weighted κ measure of agreement was very low (0.097); as such, predictions were little more than chance. This lack of predictive power was also found for each of the individual domain ratings.ConclusionThe poor power of performance of these indicators to predict subsequent inspection ratings may call into question the validity and reliability of the indicators, inspection ratings, or both. A number of changes to the way data relating to performance indicators are collected and used are suggested to improve the predictive value of indicators. It is also recommended that assessments of predictive power be undertaken prospectively when sets of indicators are being designed and selected by regulators.

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