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Developing 'high impact' guideline-based quality indicators for UK primary care: a multi-stage consensus process.
Rushforth, Bruno; Stokes, Tim; Andrews, Elizabeth; Willis, Thomas A; McEachan, Rosemary; Faulkner, Simon; Foy, Robbie.
Afiliação
  • Rushforth B; Foundry Lane Surgery, 3 Street Lane, Leeds, LS8 1BW, UK. bruno.rushforth@nhs.net.
  • Stokes T; Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. tim.stokes@otago.ac.nz.
  • Andrews E; Bradford Institute for Health Research, Bradford, UK. Elizabeth.Andrews@bthft.nhs.uk.
  • Willis TA; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK. t.a.willis@leeds.ac.uk.
  • McEachan R; Bradford Institute for Health Research, Bradford, UK. Rosie.McEachan@bthft.nhs.uk.
  • Faulkner S; Health and Social Care Information Centre, Leeds, UK. Simon.faulkner1@nhs.net.
  • Foy R; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK. r.foy@leeds.ac.uk.
BMC Fam Pract ; 16: 156, 2015 Oct 28.
Article em En | MEDLINE | ID: mdl-26507739
ABSTRACT

BACKGROUND:

Quality indicators (QIs) are an important tool for improving clinical practice and are increasingly being developed from evidence-based guideline recommendations. We aimed to identify, select and apply guideline recommendations to develop a set of QIs to measure the implementation of evidence-based practice using routinely recorded clinical data in United Kingdom (UK) primary care.

METHODS:

We reviewed existing national clinical guidelines and QIs and used a four-stage consensus development process to derive a set of 'high impact' QIs relevant to primary care based upon explicit prioritisation criteria. We then field tested the QIs using remotely extracted, anonymised patient records from 89 randomly sampled primary care practices in the Yorkshire region of England.

RESULTS:

Out of 2365 recommendations and QIs originally reviewed, we derived a set of 18 QIs (5 single, 13 composites - comprising 2-9 individual recommendations) for field testing. QIs predominantly addressed chronic disease management, in particular diabetes, cardiovascular and renal disease, and included both processes and outcomes of care. Field testing proved to be critical for further refinement and final selection.

CONCLUSIONS:

We have demonstrated a rigorous and transparent methodology to develop a set of high impact, evidence-based QIs for primary care from clinical guideline recommendations. While the development process was successful in developing a limited set of QIs, it remains challenging to derive robust new QIs from clinical guidelines in the absence of established systems for routine, structured recording of clinical care.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Atenção Primária à Saúde / Indicadores de Qualidade em Assistência à Saúde / Consenso Tipo de estudo: Guideline / Prognostic_studies Limite: Humans País/Região como assunto: America do norte Idioma: En Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Atenção Primária à Saúde / Indicadores de Qualidade em Assistência à Saúde / Consenso Tipo de estudo: Guideline / Prognostic_studies Limite: Humans País/Região como assunto: America do norte Idioma: En Ano de publicação: 2015 Tipo de documento: Article