International Comparison of Quality Indicators for Adults Hospitalized for Heart Failure: A Systematic Review.

IF 6.2 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Circulation-Cardiovascular Quality and Outcomes Pub Date : 2024-11-01 Epub Date: 2024-11-19 DOI:10.1161/CIRCOUTCOMES.123.010629

Giliana Garcia Acevedo, Aisha Ahmad, Benjamin Stall, Media Mokhtarnia, John M Lapp, Amol A Verma, Jalal Ebrahim, Harriette G C Van Spall, Fahad Razak, Sarina R Isenberg, Edward Etchells, Susanna Mak, Leah Steinberg, Dennis T Ko, Stephanie Poon, Kieran L Quinn

{"title":"International Comparison of Quality Indicators for Adults Hospitalized for Heart Failure: A Systematic Review.","authors":"Giliana Garcia Acevedo, Aisha Ahmad, Benjamin Stall, Media Mokhtarnia, John M Lapp, Amol A Verma, Jalal Ebrahim, Harriette G C Van Spall, Fahad Razak, Sarina R Isenberg, Edward Etchells, Susanna Mak, Leah Steinberg, Dennis T Ko, Stephanie Poon, Kieran L Quinn","doi":"10.1161/CIRCOUTCOMES.123.010629","DOIUrl":null,"url":null,"abstract":"Background: There is limited international agreement on defining care quality for the millions of people hospitalized with heart failure worldwide. Our objective was to compare and measure agreement across existing internationally published quality indicators (QIs) for the care of adults hospitalized for heart failure.Methods: Systematic review and evidence gap map of internationally published articles reporting on QIs for adults hospitalized for heart failure, using PubMed, MEDLINE, EMBASE, and TRIP from inception to July 18, 2022. Narrative synthesis and descriptive statistics characterized included articles and QIs using the Donabedian Framework of Structural, Process, and Outcomes. The methodological quality of QI sets was assessed using the Appraisal of Indicators through Research and Evaluation instrument. Agreement about QIs was defined as having at least 3 different cardiovascular societies recommend its use. An evidence gap map displayed each QI according to its clinically relevant category, methodological quality, and reporting articles.Results: Fourteen articles from 11 societies reported 75 unique QIs; 53 QIs were process, 16 were structural, and 7 were outcome measures. There was limited agreement on individual QIs across sets as a minority were recommended by ≥3 societies (12%; 9/75 QIs). The most common QIs included postdischarge follow-up (73%, 8/11 societies), specific pharmacotherapy (64%, 7/11 societies), patient education (45%, 5/11 societies), assessment of left ventricular ejection fraction (45%, 5/11 societies), 30-day readmission rate (45%, 5/11 societies), cardiac rehabilitation (36%, 4/11 societies), and multidisciplinary management (27%, 3/11 societies).Conclusions: There was little agreement on defining high-quality care and limited agreement on measures including postdischarge follow-up, specific pharmacotherapies, patient education, assessment of left ventricular ejection fraction, 30-day readmission, cardiac rehabilitation, and multidisciplinary management. These measures may define high-quality care and highlight opportunities to improve the quality of care for adults hospitalized for heart failure.","PeriodicalId":49221,"journal":{"name":"Circulation-Cardiovascular Quality and Outcomes","volume":"17 11","pages":"e010629"},"PeriodicalIF":6.2000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Circulation-Cardiovascular Quality and Outcomes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1161/CIRCOUTCOMES.123.010629","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/19 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: There is limited international agreement on defining care quality for the millions of people hospitalized with heart failure worldwide. Our objective was to compare and measure agreement across existing internationally published quality indicators (QIs) for the care of adults hospitalized for heart failure.

Methods: Systematic review and evidence gap map of internationally published articles reporting on QIs for adults hospitalized for heart failure, using PubMed, MEDLINE, EMBASE, and TRIP from inception to July 18, 2022. Narrative synthesis and descriptive statistics characterized included articles and QIs using the Donabedian Framework of Structural, Process, and Outcomes. The methodological quality of QI sets was assessed using the Appraisal of Indicators through Research and Evaluation instrument. Agreement about QIs was defined as having at least 3 different cardiovascular societies recommend its use. An evidence gap map displayed each QI according to its clinically relevant category, methodological quality, and reporting articles.

Results: Fourteen articles from 11 societies reported 75 unique QIs; 53 QIs were process, 16 were structural, and 7 were outcome measures. There was limited agreement on individual QIs across sets as a minority were recommended by ≥3 societies (12%; 9/75 QIs). The most common QIs included postdischarge follow-up (73%, 8/11 societies), specific pharmacotherapy (64%, 7/11 societies), patient education (45%, 5/11 societies), assessment of left ventricular ejection fraction (45%, 5/11 societies), 30-day readmission rate (45%, 5/11 societies), cardiac rehabilitation (36%, 4/11 societies), and multidisciplinary management (27%, 3/11 societies).

Conclusions: There was little agreement on defining high-quality care and limited agreement on measures including postdischarge follow-up, specific pharmacotherapies, patient education, assessment of left ventricular ejection fraction, 30-day readmission, cardiac rehabilitation, and multidisciplinary management. These measures may define high-quality care and highlight opportunities to improve the quality of care for adults hospitalized for heart failure.

查看原文本刊更多论文

成人心力衰竭住院患者质量指标的国际比较：系统回顾

背景：对于全球数百万心力衰竭住院患者的护理质量定义，国际间达成的共识十分有限。我们的目标是比较和衡量现有国际公布的成人心力衰竭住院治疗质量指标（QIs）的一致性：方法：使用 PubMed、MEDLINE、EMBASE 和 TRIP，对从开始到 2022 年 7 月 18 日国际上发表的报告成人心力衰竭住院治疗质量指标的文章进行系统回顾和证据差距图分析。采用多纳比德结构、过程和结果框架，对纳入的文章和量化指标进行了叙述性综合和描述性统计。QI集的方法学质量采用研究与评估指标评价工具进行评估。至少有 3 个不同的心血管协会推荐使用 QI，即为达成一致。证据差距图根据临床相关类别、方法学质量和报告文章显示了每个 QI：来自 11 个学会的 14 篇文章报告了 75 个独特的 QIs；其中 53 个 QIs 为过程性 QIs，16 个为结构性 QIs，7 个为结果性 QIs。由于少数 QIs 被≥3 个学会推荐（12%；9/75 QIs），因此各组 QIs 的一致性有限。最常见的量化指标包括出院后随访（73%，8/11 个学会）、特定药物治疗（64%，7/11 个学会）、患者教育（45%，5/11 个学会）、左心室射血分数评估（45%，5/11 个学会）、30 天再入院率（45%，5/11 个学会）、心脏康复（36%，4/11 个学会）和多学科管理（27%，3/11 个学会）：结论：在定义优质护理方面几乎没有达成一致意见，在出院后随访、特定药物治疗、患者教育、左心室射血分数评估、30 天再入院、心脏康复和多学科管理等措施方面的一致意见也很有限。这些措施可以定义优质护理，并突出提高成人心力衰竭住院患者护理质量的机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Circulation-Cardiovascular Quality and Outcomes CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

8.50

自引率

2.90%

发文量

357

审稿时长

4-8 weeks

期刊介绍： Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal, publishes articles related to improving cardiovascular health and health care. Content includes original research, reviews, and case studies relevant to clinical decision-making and healthcare policy. The online-only journal is dedicated to furthering the mission of promoting safe, effective, efficient, equitable, timely, and patient-centered care. Through its articles and contributions, the journal equips you with the knowledge you need to improve clinical care and population health, and allows you to engage in scholarly activities of consequence to the health of the public. Circulation: Cardiovascular Quality and Outcomes considers the following types of articles: Original Research Articles, Data Reports, Methods Papers, Cardiovascular Perspectives, Care Innovations, Novel Statistical Methods, Policy Briefs, Data Visualizations, and Caregiver or Patient Viewpoints.