Priorización de indicadores de calidad de la atención al paciente con ictus a partir de un método de consenso / Prioritization of performance measures for assessment of hospital-based stroke care quality through a consensus method

Objetivos. Definir un conjunto básico de indicadores de calidad de la atención hospitalaria del paciente con ictus, basados en la evidencia científica, a partir de la priorización consensuada por un panel de expertos representativo de los profesionales que realizan la atención hospitalaria en tres comunidades autónomas (Cataluña, Aragón y Baleares). Material y método. Un panel de 56 expertos, implicados en la atención hospitalaria de los pacientes con ictus, priorizaron mediante un método Delphi modificado en dos vueltas un set de indicadores de calidad de entre 70 indicadores identificados en la revisión de la literatura y utilizados en experiencias previas. Se consideró el consenso cuando el 75% o más de los panelistas puntuaron el indicador en el mismo tercil, en una escala de Likert 1-9. Resultados. El conjunto final de 29 indicadores comprende los mejor puntuados representativos de todas las áreas de atención hospitalaria. Un subgrupo de 5 indicadores es de aplicación únicamente en los Centros de Referencia de Ictus (Primary Stroke Centers, PSC). Los tres indicadores mejor puntuados y con el mayor consenso de los expertos son anticoagulación en la FA, antitrombóticos al alta y fisioterapia al alta gestionada. Conclusiones. A partir del método Delphi, se ha obtenido un set de indicadores actualizados, apoyados por la evidencia científica, considerados de elevada importancia y consensuados por los expertos que realizan la atención hospitalaria a los pacientes con ictus de los territorios participantes, que representan alrededor del 20% de la población española(AU)

Objectives. To define a core set of evidence-based performance indicators (PIs) for the assessment of in-hospital stroke care quality by means of consensus prioritisation by a panel of experts representing stroke care professionals in three Autonomous Communities (Catalonia, Aragon and Balearic Islands). Material and methods. We used a modified Delphi method in two rounds to prioritise a set of PIs from among 70 indicators identified by a review of the literature and those already used in previous experiences. Consensus on validity was reached when >=75% of panellists rated a PI in the top tertile, using a 1-9 Likert scale. On the basis of the percentage distribution of annual stroke admissions in each one of the 3 regions, we configured a multidisciplinary panel of 56 experts involved in the hospital care of acute stroke patients. Results. Twenty-nine out of the 70 PIs initially put forward to the panel, have been prioritised after 2 rounds. The eventual core set of PIs consists of those with the highest scores and represent all areas of hospital-based stroke care. A subgroup of 5 PIs is applicable to Primary Stroke Centres only. The 3 highest rated PIs, which achieved the greatest consensus among the experts, are anticoagulants for AF, antithrombotics at discharge and continued physiotherapy planned at discharge. Conclusions. Through a Delphi method, we have obtained a core set of evidence-based PIs considered of high importance and agreed by a multidisciplinary panel of stroke care experts from the participating Communities, which represent over 20% of the Spanish population(AU)

[Prioritization of performance measures for assessment of hospital-based stroke care quality through a consensus method]. / Priorización de indicadores de calidad de la atención al paciente con ictus a partir de un método de consenso.

OBJECTIVES: To define a core set of evidence-based performance indicators (PIs) for the assessment of in-hospital stroke care quality by means of consensus prioritization by a panel of experts representing stroke care professionals in three Autonomous Communities (Catalonia, Aragon and Balearic Islands). MATERIAL AND METHODS: We used a modified Delphi method in two rounds to prioritize a set of PIs from among 70 indicators identified by a review of the literature and those already used in previous experiences. Consensus on validity was reached when ≥ 75% of panellists rated a PI in the top tertile, using a 1-9 Likert scale. On the basis of the percentage distribution of annual stroke admissions in each one of the 3 regions, we configured a multidisciplinary panel of 56 experts involved in the hospital care of acute stroke patients. RESULTS: Twenty-nine out of the 70 PIs initially put forward to the panel, have been prioritized after 2 rounds. The eventual core set of PIs consists of those with the highest scores and represent all areas of hospital-based stroke care. A subgroup of 5 PIs is applicable to Primary Stroke Centres only. The 3 highest rated PIs, which achieved the greatest consensus among the experts, are anticoagulants for AF, antithrombotics at discharge and continued physiotherapy planned at discharge. CONCLUSIONS: Through a Delphi method, we have obtained a core set of evidence-based PIs considered of high importance and agreed by a multidisciplinary panel of stroke care experts from the participating Communities, which represent over 20% of the Spanish population.