Observations from the Field: Reporting Quality Metrics in Health Care

2016 ◽  
Vol 6 (7) ◽  
Author(s):  
Nancy E. Dunlap ◽  
◽  
David J. Ballard ◽  
Robert A. Cherry ◽  
Wm. Claiborne Dunagan ◽  
...  
Keyword(s):  
Health Care ◽  
Reporting Quality ◽  
Quality Metrics

Quality Metrics and Health Care Utilization for Adult Patients with Sickle Cell Disease

2019 ◽  
Vol 111 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Monica Ter-Minassian ◽  
Sophie Lanzkron ◽  
Alphonse Derus ◽  
Elizabeth Brown ◽  
Michael A. Horberg
Keyword(s):  
Health Care ◽  
Sickle Cell Disease ◽  
Health Care Utilization ◽  
Sickle Cell ◽  
Quality Metrics ◽  
Adult Patients ◽  
Care Utilization ◽  
Cell Disease

scholarly journals A Systematic Review of Ultrasound Imaging As a Tool for Evaluating Hemophilic Arthropathy in Children and Adults

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4464-4464
Author(s):  
Aryan Abadeh ◽  
Carolina de Carvalho Ligocki ◽  
Kuan Chung Wang ◽  
Thomasin Adams-Webber ◽  
Victor S. Blanchette ◽  
...  
Keyword(s):  
Health Care ◽  
Early Diagnosis ◽  
Diagnostic Accuracy ◽  
Board Of Directors ◽  
Methodological Quality ◽  
Reporting Quality ◽  
Scoring Systems ◽  
Data Safety Monitoring Board ◽  
Advisory Committees ◽  
Hemophilic Arthropathy

Abstract PURPOSE: To semi-quantitatively assess the evidence on the value of ultrasound (US) for assessment of hemophilic arthropathy (HA) in children and adults. We sought to provide the answer to the following questions: (1) Are currently available US techniques accurate for early diagnosis of pathological findings? (2) Can treatment reduce the incidence of US-detectable findings in HA? (3) Do US scores correlate with clinical/radiological constructs in the evaluation of HA? (4) Are US findings associated with functional status of joints? METHODS: Articles were screened using MEDLINE (n= 519), EMBASE (n= 493), and the Cochrane Library (n=24) (1946-2015). Two independent reviewers assessed the reporting quality and the methodological quality of articles by using the Standards for Reporting of Diagnostic Accuracy (STARD) and the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tools respectively. 4 different US scanning protocols for assessment of hemophilic joints were compared based on scanning times and anatomical landmarks. 6 US scoring systems were also compared according to number of soft-tissue and osteochondral parameters evaluated. RESULTS: Out of 16 full-text articles, 9 diagnostic accuracy studies (417 patients with hemophilia A, B and von Willebrand's disease) were evaluated for reporting and methodological quality using STARD and QUADAS-2 assessment tools respectively. Seven studies were of moderate reporting quality and 2 of low reporting quality. When using QUADAS-2, 1 study was of high, 3 of moderate, 2 of low, and 3 of very low methodological quality. Out of 9 diagnostic accuracy studies, 1 evaluated HA in ankles, knees, elbows, and shoulders while 3 evaluated ankles, knees, and elbows and only 2 evaluated ankles and knees. 2 more studies focused solely on knees and 1 on shoulders. Six US interpretation scores were reviewed and compared. All 6 articles included synovial hypertrophy in their evaluation. 5 articles incorporated cartilage modification while only 2 articles assessed hemosiderin deposition in their evaluation. Among these 6 scores, 4 were of moderate reporting quality, 1 of low and 1 of very low reporting quality. When using QUADAS-2 however, only 1 study was of high, 1 of moderate, 2 of of low, and 2 of very low methodological quality. Four US scanning protocols were also assessed, all evaluated the joints in both prone and supine positions. 3 suggested an extended scanning procedure of up to 30 minutes per joint, while 1 proposed a more simplified procedure. Two scanning protocols evaluated knees and ankles, while one focused on elbows. Only one scanning protocol included ankles, knees, and elbows in its assessment. CONCLUSIONS: There is insufficient evidence (Grade I) to recommend US as an accurate technique for early diagnosis of pathologic findings, to demonstrate that US scores correlate with clinical/radiological constructs, that treatment can reduce the incidence of US-detectable findings in HA, and to prove an association between US findings and the functional status of the joint. Further studies are required to establish standardized US scanning protocols and scoring systems and to determine US as a valuable tool for early diagnosis of hemophilic arthropathy (HA) in children and adults. ACKNOWLEDGEMENTS: This work was funded by Novo Nordisk Health Care AG. Disclosures Abadeh: Novo Nordisk Health Care AG: Other: Funding. Blanchette:Bayer Healthcare: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Pfizer: Honoraria, Membership on an entity's Board of Directors or advisory committees; Octapharma: Other: Data Safety Monitoring Board; Novo Nordisk: Honoraria, Membership on an entity's Board of Directors or advisory committees; Baxter Corporation: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Data Safety Monitoring Board, Research Funding. Doria:Novo Nordisk Health Care AG: Other: Funding.

Development of a comprehensive set of colorectal cancer care quality metrics.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 670-670
Author(s):  
Laurence E. McCahill ◽  
Jamie Kokko ◽  
Chris Werkemma ◽  
Pierson Ebrom ◽  
Sarat Khandavalli
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Rectal Cancer ◽  
Cancer Care ◽  
Quality Metrics ◽  
Care Quality ◽  
Post Treatment ◽  
Care Providers ◽  
Care Surgery

670 Background: Institute of Medicine report calls for improved quality of cancer care. Numerous entities have sought measures of health care quality, but there is limited consensus regarding metrics for quality of colorectal cancer (CRC) care. Current measures are very limited; there exist no comprehensive metrics for quality of CRC care across the continuum of care. We sought to identify robust quality metrics, including measures related to pathology, coordination of cancer care, surgery, radiation, chemotherapy and surveillance, in order to identify gaps in quality of CRC care. Methods: National guidelines (NCCN and ASCO), National Quality Forum, and select peer reviewed publications were reviewed to develop evidence based metrics to assess quality of CRC care from diagnosis to post treatment surveillance and survivorship. A core group of health care providers, including a surgical oncologist, a pathologist and a Cancer nurse practitioner developed the metrics based on literature review. Measures were reviewed by key physician stakeholders including Radiation Oncology, Medical Oncology, General surgery, and Gastroenterology to obtain support for the quality initiative at our institution. Results: Twenty-three quality metrics were developed including 6 metrics related to access and process, 6 related to pathology, 7 related to multidisciplinary care and 4 measures related to surveillance and survivorship. Novel metrics included documentation of a three generational cancer family history, documentation of preoperative CT imaging of chest/abdomen/pelvis, MSI and KRAS testing in specific populations, appropriate pre-operative radiation oncologist evaluation for rectal cancer, multidisciplinary team planning prior to treatment initiation for rectal cancer and patients with newly identified liver metastases, appropriate referral for genetic counseling and surveillance annual CT scans for 3 years post treatment. Conclusions: These novel and comprehensive metrics allow for detailed review of the quality of CRC care received by patients at our institution. Individual patient data are currently being abstracted to assess the utility and logistics of implementing these quality metrics at a community cancer center.

scholarly journals Measuring and Reporting Quality of Health Care for Children: CHIPRA and Beyond

2011 ◽  
Vol 11 (3) ◽  
pp. S77-S84 ◽  
Author(s):  
Gerry Fairbrother ◽  
Lisa A. Simpson
Keyword(s):  
Health Care ◽  
Quality Of Health Care ◽  
Reporting Quality

scholarly journals An Environmental Scan of Canadian Quality Metrics for Patients on In-Center Hemodialysis

2020 ◽  
Vol 7 ◽  
pp. 205435812097531
Author(s):  
Daniel Blum ◽  
Alison Thomas ◽  
Claire Harris ◽  
Jay Hingwala ◽  
William Beaubien-Souligny ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Quality Indicators ◽  
Quality Metrics ◽  
Care Quality ◽  
Environmental Scan ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Effective Care ◽  
Starting Point

Background: Quality metrics or indicators help guide quality improvement work by reporting on measurable aspects of health care upon which improvement efforts can focus. For recipients of in-center hemodialysis (ICHD) in Canada, it is unclear what ICHD quality indicators exist and whether they adequately cover different domains of health care quality. Objectives: To identify and evaluate current Canadian ICHD quality metrics to document a starting point for future collaborations and standardization of quality improvement in Canada. Design: Environmental scan of quality metrics in ICHD, and subsequent indicator evaluation using a modified Delphi approach. Setting: Canadian ICHD units. Participants: Sixteen-member pan-Canadian working group with expertise in ICHD and quality improvement. Measurements: We classified the existing indicators based on the Institute of Medicine (IOM) and Donabedian frameworks. Methods: Each metric was rated by a 5-person subcommittee using a modified Delphi approach based on the American College of Physicians/Agency for Healthcare Research and Quality criteria. We shared these consensus ratings with the entire 16-member panel for additional comments. Results: We identified 27 metrics that are tracked across 8 provinces, with only 9 (33%) tracked by multiple provinces (ie, more than 1 province). We rated 9 metrics (33%) as “necessary” to distinguish high-quality from low-quality care, of which only 2 were tracked by multiple provinces (proportion of patients by primary access and rate of vascular access-related bloodstream infections). Most (16/27, 59%) indicators assessed the IOM domains of safe or effective care, and none of the “necessary” indicators measured the IOM domains of timely, patient-centered, or equitable care. Limitations: The environmental scan is a nonexhaustive list of quality indicators in Canada. The panel also lacked representation from patients, administrators, and allied health professionals, with more representation from academic sites. Conclusions: Quality indicators in Canada mainly focus on safe and effective care, with little provincial overlap. These results highlight current gaps in quality of care measurement for ICHD, and this initial work should provide programs with a starting point to combine highly rated indicators with newly developed indicators into a concise balanced scorecard that supports quality improvement initiatives across all aspects of ICHD care. Trial Registration: not applicable.

Hospital- and System-Wide Interventions for Health Care-Associated Infections: A Systematic Review

2020 ◽  
pp. 107755872095292
Author(s):  
Nicholas R. Maurer ◽  
Tory H. Hogan ◽  
Daniel M. Walker
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Staphylococcus Aureus ◽  
Statistical Analysis ◽  
Clostridium Difficile ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Reporting Quality ◽  
Health Care Associated Infections ◽  
The Relationship ◽  
Research And Policy

Hospitals face increasing pressure to reduce health care-associated infections (HAI) due to their costs and evidence of preventability. However, there is limited synthesis of evidence regarding interventions that can be successfully implemented hospital- or system-wide. Using Donabedian’s structure-process-outcome model, we conducted a systematic literature review from 2008 to early 2019, identifying 96 studies with 214 outcomes examining the relationship between hospital- or system-wide interventions and HAIs. This literature’s methodologic and reporting quality was generally poor. The most common HAIs studied were methicillin-resistant Staphylococcus aureus (22%) and Clostridium difficile (21%). 97 outcomes showed a desirable change, 72 showed no significant effect, 17 showed conflicting effects, and 3 found undesirable effects; 25 outcomes were from studies without a statistical analysis. Our findings highlight structural and process approaches meriting additional research and policy exploration, and identify recommendations for future investigation and reporting of hospital and system-wide HAI interventions to address gaps in existing literature.

The exchangeability of self-reports and administrative health care resource use measurements: assessement of the methodological reporting quality

2016 ◽  
Vol 74 ◽  
pp. 93-106.e2 ◽  
Author(s):  
Cindy Yvonne Noben ◽  
Angelique de Rijk ◽  
Frans Nijhuis ◽  
Jan Kottner ◽  
Silvia Evers
Keyword(s):  
Health Care ◽  
Resource Use ◽  
Reporting Quality ◽  
Health Care Resource ◽  
Self Reports ◽  
Health Care Resource Use
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