scholarly journals European Society of Cardiology methodology for the development of quality indicators for the quantification of cardiovascular care and outcomes

2020 ◽  
Author(s):  
Suleman Aktaa ◽  
Gorav Batra ◽  
Lars Wallentin ◽  
Colin Baigent ◽  
David Erlinge ◽  
...  
Keyword(s):  
Quality Indicators ◽  
European Society ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Implementation Process ◽  
Feasibility Assessment ◽  
Expert Opinions ◽  
European Society Of Cardiology ◽  
Cardiovascular Care

Abstract Aims It is increasingly recognized that tools are required for assessing and benchmarking quality of care in order to improve it. The European Society of Cardiology (ESC) is developing a suite of quality indicators (QIs) to evaluate cardiovascular care and support the delivery of evidence-based care. This paper describes the methodology used for their development. Methods and results We propose a four-step process for the development of the ESC QIs. For a specific clinical area with a gap in care delivery, the QI development process includes: (i) the identification of key domains of care by constructing a conceptual framework of care; (ii) the construction of candidate QIs by conducting a systematic review of the literature; (iii) the selection of a final set of QIs by obtaining expert opinions using the modified Delphi method; and (iv) the undertaking of a feasibility assessment by evaluating different ways of defining the QI specifications for the proposed data collection source. For each of the four steps, key methodological areas need to be addressed to inform the implementation process and avoid misinterpretation of the measurement results. Conclusion Detailing the methodology for the ESC QIs construction enables healthcare providers to develop valid and feasible metrics to measure and improve the quality of cardiovascular care. As such, high-quality evidence may be translated into clinical practice and the ‘evidence-practice’ gap closed.

The development of quality indicators to improve psychosocial care in dementia

2012 ◽  
Vol 24 (6) ◽  
pp. 921-930 ◽  
Author(s):  
Emmelyne Vasse ◽  
Esme Moniz-Cook ◽  
Marcel Olde Rikkert ◽  
Inge Cantegreil ◽  
Kevin Charras ◽  
...  
Keyword(s):  
Quality Indicators ◽  
Psychosocial Care ◽  
Implementation Process ◽  
Psychosocial Interventions ◽  
Dementia Care ◽  
Face Validity ◽  
Modified Delphi ◽  
Modified Delphi Technique ◽  
Multinational Strategy

ABSTRACTBackground: The evidence for the effectiveness of psychosocial interventions in dementia care is growing but the implementation of available evidence is not automatic. Our objective was to develop valid quality indicators (QIs) for psychosocial dementia care that facilitate the implementation process in various countries and settings.Methods: A RAND-modified Delphi technique was used to develop a potential set of QIs. Two multidisciplinary, international expert panels were involved in achieving content and face validity. Consensus on the final set was reached after a conference meeting where a third panel of dementia experts discussed measurability and applicability of the potential set. A retrospective cohort study was conducted to study the feasibility of using the final set in day care centers, hospitals, and nursing homes in Spain and The Netherlands.Results: A total of 104 recommendations were selected from guidelines and systematic reviews and appraised for their contribution to improving the quality of dementia care by 49 dementia experts. Twenty-five experts attended the conference meeting and reached consensus on a set of 12 QIs representing the key elements of effective psychosocial care, such as shared decision-making and interventions tailored to needs and preferences. Data from 153 patient records showed that all but one QI subitem were applicable to all three settings in both countries.Conclusion: Our multidisciplinary and multinational strategy resulted in a set of unique QIs that aims exclusively at assessing the quality of psychosocial dementia care. Following implementation, these QIs will assist dementia care professionals to individualize and tailor psychosocial interventions.

scholarly journals Culture and Quality in Government General Hospitals in Kuwait: A Multimethod Study of their Association with the Transformational Leadership

2020 ◽  
Author(s):  
Talal AlFadhala ◽  
Hossam Elamir ◽  
Hoda Zaki Helmy
Keyword(s):  
Transformational Leadership ◽  
Quality Of Care ◽  
Quality Indicators ◽  
Leadership Style ◽  
Care Delivery ◽  
Organisational Culture ◽  
Multi Centre Study ◽  
General Hospitals ◽  
Transformational Leadership Style

Background Although there are many healthcare leaders and an ongoing quality programme in the national healthcare system in Kuwait, study of the relationship of leadership style to organisational culture and quality of care is lacking. Methods We report a multi-centre study that used cross-sectional and retrospective quantitative approaches in the government-sponsored secondary care setting in Kuwait. A sample of 1,626 was drawn from a frame of 9,863 physicians, nurses, and pharmacists in 6 general hospitals. Followers were surveyed using the Multifactor Leadership and the Organizational Description Questionnaires. We reviewed and analysed the past one year of quarterly and annual quality indicators of the studied hospitals. Data were analysed using Statistical Package for the Social Sciences (SPSS) Version 15.0. Results According to followers, 66.4% to 87.1% of participants in the six hospitals identified their hospital organisational culture as transformational, while 41 out of 48 departments were identified as having a transformational culture. The participants who rated their leader and organisational culture as transformational ranged from 60.5% to 80.4% in different hospitals, and 8.5% of participants in only 1 hospital scored their leader as transformational and their culture as transactional. The differences between leadership style and organizational culture were statistically significant for four hospitals. Regarding the quality indicators, there was an indirect non-significant correlation between a transformational leadership style and most hospitals' indicators. Conclusions Transformational leaders are definers and givers of culture. The prevailing transformational leadership style creates and maintains the kind of transformational organisational culture. Our work here indicates how a given leadership style affects statistics of indicators that reflect the quality of care delivery observed in hospitals. However, this relationship is statistically insignificant. This relationship needs further research.

scholarly journals Assessment of quality indicators for acute myocardial infarction management in 28 countries and use of composite quality indicators for benchmarking

2020 ◽  
Vol 9 (8) ◽  
pp. 911-922 ◽  
Author(s):  
Xavier Rossello ◽  
Jesús Medina ◽  
Stuart Pocock ◽  
Frans Van de Werf ◽  
Chee Tang Chin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Quality Indicators ◽  
European Society ◽  
Prognostic Value ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
European Society Of Cardiology ◽  
Elevation Acute Myocardial Infarction

Background: The European Society of Cardiology established a set of quality indicators for the management of acute myocardial infarction. Our aim was to evaluate their degree of attainment, prognostic value and potential use for centre benchmarking in a large international cohort. Methods: Quality indicators were extracted from the long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients (EPICOR) (555 hospitals, 20 countries in Europe and Latin America, 2010–2011) and EPICOR Asia (218 hospitals, eight countries, 2011–2012) registries, including non-ST-segment elevation acute myocardial infarction ( n=6558) and ST-segment elevation acute myocardial infarction ( n=11,559) hospital survivors. The association between implementation rates for each quality indicator and two-year adjusted mortality was evaluated using adjusted Cox models. Composite quality indicators were categorized for benchmarking assessment at different levels. Results: The degree of attainment of the 17 evaluated quality indicators ranged from 13% to 100%. Attainment of most individual quality indicators was associated with two-year survival. A higher compliance with composite quality indicators was associated with lower mortality at centre-, country- and region-level. Moreover, the higher the risk for two-year mortality, the lower the compliance with composite quality indicators. Conclusions: When EPICOR and EPICOR Asia were conducted, the European Society of Cardiology quality indicators would have been attained to a limited extent, suggesting wide room for improvement in the management of acute myocardial infarction patients. After adjustment for confounding, most quality indicators were associated with reduced two-year mortality and their prognostic value should receive further attention. The two composite quality indicators can be used as a tool for benchmarking either at centre-, country- or world region-level.

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