ABSTRACT
Antecedentes y objetivo: La espondiloartritis axial es una enfermedad inmunomediada con un elevado coste, retraso diagnóstico y complicaciones asociadas, lo que la convierte en una enfermedad con especial importancia. Este trabajo busca por consenso establecer un modelo de certificación (Proyecto SpACE) para consultas monográficas en su diagnóstico y tratamiento. Materiales y métodos: Estudio cualitativo de consenso, a través de la técnica del grupo nominal. Primero, fue realizada una revisión pragmática de la literatura. Segundo, fueron incluidos profesionales involucrados a lo largo del proceso asistencial (reumatología, oftalmología, gastroenterología, traumatología, medicina de familia, fisioterapia y enfermería). Resultados: Producto de la revisión pragmática de la literatura fueron extraídos 37 posibles estándares. Durante la fase de consenso solo aquellos estándares con una elevada factibilidad e importancia en el proceso asistencial fueron priorizados. Finalmente, el grupo de 26 expertos acordó la inclusión de 14 estándares. Discusión y conclusiones: SpaCE es una norma de certificación, fruto del consenso, que busca mejorar los resultados en salud y una atención más integrada.(AU)
Background and objective: Axial spondyloarthritis is an immune-mediated disease with a high cost, diagnostic delay and associated complications that makes it a particularly important condition. This work aims to establish a certification standard (SpACE Project) for monographic consultations in its diagnosis and treatment. Materials and methods: Qualitative study of consensus, through the technique of the nominal group. First, a pragmatic review of the literature was carried out. Second, professionals involved throughout the care process (rheumatology, ophthalmology, gastroenterology, traumatology, family medicine, physical therapy, and nursing) were included. Results: Thirty-seven possible standards were extracted from the pragmatic review of the literature. During the consensus phase only those standards with high feasibility and importance in the care process were prioritized. Finally, the group of 26 experts agreed on the inclusion of 14 standards. Discussion and conclusions: SpaCE is a consensus-based certification standard that seeks to improve health outcomes and more integrated care.(AU)
Subject(s)
Humans , Spondylarthritis/drug therapy , Spine , Pain , Chronic Pain , Arthritis , RheumatologyABSTRACT
BACKGROUND AND OBJECTIVE: Axial spondyloarthritis is an immune-mediated disease with a high cost, diagnostic delay and associated complications that makes it a particularly important condition. This work aims to establish a certification standard (SpACE Project) for monographic consultations in its diagnosis and treatment. MATERIALS AND METHODS: Qualitative study of consensus, through the technique of the nominal group. First, a pragmatic review of the literature was carried out. Second, professionals involved throughout the care process (rheumatology, ophthalmology, gastroenterology, traumatology, family medicine, physical therapy, and nursing) were included. RESULTS: Thirty-seven possible standards were extracted from the pragmatic review of the literature. During the consensus phase only those standards with high feasibility and importance in the care process were prioritized. Finally, the group of 26 experts agreed on the inclusion of 14 standards. DISCUSSION AND CONCLUSIONS: SpACE is a consensus-based certification standard that seeks to improve health outcomes and more integrated care.
Subject(s)
Axial Spondyloarthritis , Rheumatology , Certification , Delayed Diagnosis , Humans , Surveys and QuestionnairesABSTRACT
BACKGROUND AND OBJECTIVE: Axial spondyloarthritis is an immune-mediated disease with a high cost, diagnostic delay and associated complications that makes it a particularly important condition. This work aims to establish a certification standard (SpACE Project) for monographic consultations in its diagnosis and treatment. MATERIALS AND METHODS: Qualitative study of consensus, through the technique of the nominal group. First, a pragmatic review of the literature was carried out. Second, professionals involved throughout the care process (rheumatology, ophthalmology, gastroenterology, traumatology, family medicine, physical therapy, and nursing) were included. RESULTS: Thirty-seven possible standards were extracted from the pragmatic review of the literature. During the consensus phase only those standards with high feasibility and importance in the care process were prioritized. Finally, the group of 26 experts agreed on the inclusion of 14 standards. DISCUSSION AND CONCLUSIONS: SpaCE is a consensus-based certification standard that seeks to improve health outcomes and more integrated care.
ABSTRACT
In Spain, the QUANTUM project has been promoted to reduce variability in clinical practice and improve the care and quality of life of people with psoriatic arthritis (PsA) by accrediting PsA units throughout the Spanish national health system. To present the results of this approach which sought to ensure an optimum level of quality for patients with PsA. Descriptive analysis of the self-assessments that the PsA units have carried out assessing their degree of compliance with the quality standards established in the QUANTUM project grouped into four blocks: shortening time to diagnosis; optimizing disease management; improving multidisciplinary collaboration; and improving patient monitoring. A total of 41 PsA units were self-evaluated. They met 64.1% of the defined quality standards. Optimize disease management obtained a higher level of standards compliance (72%) and improve multidisciplinary collaboration the lesser (63.9%). Accessibility to the treatments available for PsA in all hospitals was guaranteed (100%). Appropriate diagnostic equipment is available (97.6%). Compliance with specific quality standards leads to detect actions that should be implemented: quality of life assessment (9.8%), locomotor system assessment (12.2%), physical examination data record (14.6%), periodic cardiovascular risk assessment (17.1%). The QUANTUM project results make it possible to visualise how to care for patients with PsA is being developed in Spain. Problems identified in recent multinational reports are also identified in Spain.
