Résumé
RATIONALE: Quality indicators are evidence-based structures, processes and outcomes of care associated with such a strong benefit that failure to address them reduces likelihood of good health outcomes. OBJECTIVES: Our objective was to use synthesized evidence and diverse expert opinion to create a comprehensive set of evidence-based COPD quality indicators spanning the health care continuum from prevention to outcome. METHODS: COPD quality indicators were developed using a modified RAND Appropriateness Method consisting of a systematic review of the medical literature followed by a Delphi method survey. The review took place in three parts: searching first for existing high quality COPD quality indicators, then for meta-analyses and systematic reviews and, lastly, for individual studies. The Delphi method had an expert panel rate and discussed the indicators in an in-person meeting followed by rounds of electronic surveys until consensus was reached. RESULTS: The systematic review produced 26 highly rated quality indicators, and 10,002 titles for further assessment. Of these, 32 full-text articles provided supporting evidence for 39 additional COPD quality indicators, for 65 in total. After rounds of review by the expert panel, a final list of 33 quality indicators was endorsed by all. CONCLUSIONS: We generated a comprehensive set of 33 evidence-based COPD quality indicators. These can be used to measure current quality of COPD health and healthcare, develop and implement strategies to improve it and otherwise provide a foundation for quality improvement. Before using in other jurisdictions, these made-in-Canada indicators should be validated to ensure they address their unique circumstances.
| Langue d'origine | English |
|---|---|
| Pages (de-à) | 30-38 |
| Nombre de pages | 9 |
| Journal | Canadian Journal of Respiratory, Critical Care, and Sleep Medicine |
| Volume | 3 |
| Numéro de publication | 1 |
| DOI | |
| Statut de publication | Published - janv. 2 2019 |
Note bibliographique
Funding Information:This work was supported by a MOHLTC Health System Research Fund Capacity Award, the Ontario Ministry of Health and Long-Term Care (MOHLTC), and in-kind contributions from the Ontario Lung Association. This study was also supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. A.S. Gershon is supported by a Canadian Institutes of Health Research New Investigator Award and was supported by a PSI Graham Farquharson Knowledge Translation Fellowship while working on this study. K.T. is supported by a Research Scholar Award from the Department of Family and Community Medicine at the University of Toronto. The authors would like to thank all the members of the expert panel for their participation and expertise: Robin Brown, Madonna Ferrone, Roger Goldstein, Donna Goodridge, Samir Gupta, Alan Kaplan, John Li, Marilyn Sorochan, Ann Taite, Itamar Tamari, Laurie Taylor, Shannon Walker, and Pamela Wilton. We would also like to thank our moderator for the in-person expert panel consensus meeting, Sara Han of the Ontario Lung Association. Furthermore, we would like to thank Gail Dechman for her assistance with reviewing the quality of identified studies.
Publisher Copyright:
© 2018, © 2018 The Author(s). Published with license by Taylor & Francis Group, LLC.
ASJC Scopus Subject Areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine