通过 e-Delphi 生成评估家庭住院医疗质量的指标。

IF 1.2 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES
Carolina Puchi, Tatiana Paravic-Klijn, Alide Salazar
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引用次数: 0

摘要

背景和目的:不同国家使用简单的指标和临床结果来衡量居家医院(HaH)的医疗质量,但这些指标和结果只能反映医疗质量的某些方面。我们试图通过 e-Delphi 技术来生成指标,以全面评估为 HaH 用户提供的医疗质量:方法:在 17 位 HaH 专家的参与下,我们采用了 e-Delphi 技术。本研究采用的方法策略分为以下三个阶段:准备阶段、咨询阶段和共识阶段。与专家进行了三轮磋商。在第一轮磋商中,专家们被要求确定他们认为应使用以下 6 个医疗质量维度中的每个维度的指标来评估 HaH 的哪些方面:有效性、效率、及时性、以患者为中心的护理、公平性和安全性。在第二轮中,他们被要求使用 5 点李克特(Likert)量表对每项指标进行评分,分值如下:(1)完全不同意;(2)不同意;(3)比较同意;(4)同意;(5)完全同意。每项指标的评价标准如下:(1) 该指标是评估为哈医用户提供的医疗质量的有用措施。(2) 指标写得清楚具体,无需修改。(3) 指标必不可少,并包含可从哈医大计划记录中提取的信息。如果一项指标在每项评估标准上都获得了专家小组至少 65% 的认可,则该指标被视为获得认可。在第三轮中,专家们被要求结合其他专家的意见重新评估他们的评级。这项技术的可靠性通过可信度、可靠性和可确认性得到了保证。我们获得了相应机构的伦理批准和参与专家的知情同意:结果:产生了 9 个未发表的可靠指标。此外,还纳入了 13 项指标,这些指标评估了其他作者和/或国内和国际机构以前分析过的方面,并对其进行了调整,以用于 HaH。生成的全部指标(n = 22)代表了医疗质量的所有方面:安全、机会、效果、效率、公平和以患者为中心的护理:结论:通过 e-Delphi 技术生成的 22 项指标可以全面评估为 HaH 用户提供的医疗质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Generation of Indicators to Assess Quality of Health Care in Hospital at Home Through e-Delphi.

Background and objectives: The quality of health care in hospital at home (HaH) has been measured in different countries using simple indicators and clinical results that only contribute to some dimensions of the quality of health care. We sought to generate indicators to comprehensively evaluate the quality of health care provided to HaH users through the e-Delphi technique.

Methods: The e-Delphi technique was performed with the participation of 17 HaH experts. The methodological strategy applied in this study was divided into the following 3 phases: a preparatory phase; consultation phase; and consensus phase. Three rounds of consultations were conducted with experts. In round 1, they were asked to identify which aspects of HaH they believed should be evaluated using an indicator for each of the following 6 dimensions of health care quality: effectiveness; efficiency; timeliness; patient-centered care; equity; and safety. In round 2, they were asked to rate each indicator using a 5-point Likert-type scale with the following values: (1) Totally disagree; (2) Disagree; (3) Moderately agree; (4) Agree; and (5) Totally agree. The criteria for evaluating each indicator were as follows: (1) The indicator is a useful measure for assessing the quality of health care provided to HaH users. (2) The indicator is clearly and specifically written and does not require modification. (3) The indicator is essential and incorporates information that can be extracted from HaH program records. An indicator was considered approved if it received at least 65% approval from the expert panel for each evaluation criterion. In round 3, experts were asked to reassess their ratings, taking into account the opinions of the other experts. The reliability of this technique was ensured through credibility, reliability, and confirmability. We obtained ethical approval of the corresponding institutions and informed consent from the participating experts.

Results: Nine unpublished and reliable indicators were generated. In addition, 13 indicators were incorporated that evaluate aspects previously analyzed by other authors and/or national and international institutions, which were adapted to be used in HaH. The total indicators generated (n = 22) represented all dimensions of the quality of health care: safety; opportunity; effectiveness; efficiency; equity; and patient-centered care.

Conclusions: The 22 indicators generated through the e-Delphi technique permit a comprehensive evaluation of the quality of health care provided to HaH users.

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来源期刊
Quality Management in Health Care
Quality Management in Health Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
1.90
自引率
8.30%
发文量
108
期刊介绍: Quality Management in Health Care (QMHC) is a peer-reviewed journal that provides a forum for our readers to explore the theoretical, technical, and strategic elements of health care quality management. The journal''s primary focus is on organizational structure and processes as these affect the quality of care and patient outcomes. In particular, it: -Builds knowledge about the application of statistical tools, control charts, benchmarking, and other devices used in the ongoing monitoring and evaluation of care and of patient outcomes; -Encourages research in and evaluation of the results of various organizational strategies designed to bring about quantifiable improvements in patient outcomes; -Fosters the application of quality management science to patient care processes and clinical decision-making; -Fosters cooperation and communication among health care providers, payers and regulators in their efforts to improve the quality of patient outcomes; -Explores links among the various clinical, technical, administrative, and managerial disciplines involved in patient care, as well as the role and responsibilities of organizational governance in ongoing quality management.
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