Quality Indicators for Inflammatory Bowel Disease: Development of Process and Outcome Measures

被引：118

作者：

Melmed, Gil Y. ^{[1
,2
]}

Siegel, Corey Allan ^{[3
,4
]}

Spiegel, Brennan M. ^{[2
,5
,6
,7
]}

Allen, John I. ^{[8
]}

Cima, Robert ^{[9
]}

Colombel, Jean-Frederic ^{[10
]}

Dassopoulos, Themistocles ^{[11
]}

Denson, Lee A. ^{[12
]}

Dudley-Brown, Sharon ^{[13
]}

Garb, Andrew ^{[14
]}

Hanauer, Stephen B. ^{[15
]}

Kappelman, Michael D. ^{[16
]}

Lewis, James D. ^{[20
]}

Lynch, Isabelle ^{[21
]}

Moynihan, Amy ^{[3
,4
]}

Rubin, David T. ^{[15
]}

Sartor, R. Balfour ^{[17
,18
,19
]}

Schwartz, Ronald M. ^{[22
]}

Wolf, Douglas C. ^{[23
]}

Ullman, Thomas A. ^{[24
]}

机构：

[1] Cedars Sinai Med Ctr, Dept Med, Los Angeles, CA 90048 USA

[2] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA

[3] Dartmouth Hitchcock Med Ctr, Dept Gastroenterol, Lebanon, NH 03766 USA

[4] New Hampshire & Dartmouth Inst Hlth Policy & Clin, Hanover, NH USA

[5] VA Greater Angeles Healthcare Syst, Dept Gastroenterol, Los Angeles, CA USA

[6] CURE Digest Dis Res Ctr, Los Angeles, CA USA

[7] UCLA VA Ctr Outcomes Res & Educ, Los Angeles, CA USA

[8] Minnesota Gastroenterol, Dept Gastroenterol, Minneapolis, MN USA

[9] Mayo Clin, Dept Surg, Rochester, MN USA

[10] Icahn Sch Med Mt Sinai, New York, NY USA

[11] Washington Univ Sch Med, Dept Gastroenterol, St Louis, MO USA

[12] Cincinnati Childrens Hosp, Dept Pediat, Cincinnati, OH USA

[13] Johns Hopkins Univ, JSch Med & Nursing, Baltimore, MD USA

[14] Loeb & Loeb, Los Angeles, CA USA

[15] Univ Chicago, Dept Med & Gastroenterol, Chicago, IL 60637 USA

[16] Univ N Carolina, Dept Pediat, Chapel Hill, NC USA

[17] Univ N Carolina, Dept Med, Chapel Hill, NC USA

[18] Univ N Carolina, Dept Microbiol, Chapel Hill, NC USA

[19] Univ N Carolina, Dept Immunol, Chapel Hill, NC USA

[20] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA

[21] VA San Francisco, Dept Gastroenterol, San Francisco, CA USA

[22] Minnesota Gastroenterol, Minneapolis, MN USA

[23] Atlanta Gastroenterol Associates, Atlanta, GA USA

[24] Mt Sinai Sch Med, Dept Med, Dr Henry Janowitz Div Gastroenterol, New York, NY USA

来源：

INFLAMMATORY BOWEL DISEASES | 2013年 / 19卷 / 03期

关键词：

inflammatory bowel disease; Crohn's disease; ulcerative colitis; quality; quality indicators; quality of care; quality measures; ULCERATIVE-COLITIS; CROHNS-DISEASE; ARTHRITIS CARE; OF-CARE; SET; MANAGEMENT; ADULTS; GUIDELINES; CHILDREN; EXPERTS;

D O I：

10.1097/mib.0b013e31828278a2

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Introduction: Variation in adherence to management guidelines for inflammatory bowel disease (IBD) suggests variable quality of care. Quality indicators (QIs) can be developed to measure the structure, processes, and outcomes of health care delivery. The RAND/UCLA appropriateness method was used to develop a set of process and outcome QIs to define quality of care for IBD. Methods: Guidelines and position papers for IBD published from 2006 to 2011 were reviewed for potential QIs, which were rated by a multidisciplinary panel. Potential process and outcome QIs were discussed at 3 moderated in-person meetings, with pre-meeting and post-meeting confidential electronic voting. Panelists rated the validity and feasibility of QIs on a 1 through 9 scale; disagreement was assessed using a validated index. QIs rated above 8 were selected for the final set. Results: More than 500 potential process QIs were extracted from guidelines. Following ratings and discussion by the first panel, 35 process QIs were selected for literature review. After the second panel, 10 process QIs were included in the final set. Candidate outcome QIs were then derived from physician, nurse, and patient input and ratings, in addition to outcomes associated with candidate process QIs. None of the top QIs exhibited disagreement. Conclusions: A set of QIs for IBD was developed with expert interpretation of the literature and multidisciplinary input. Outcome QIs focused largely on remission and quality of life, whereas process QIs were aimed at therapeutic optimization and patient safety. Evaluation of these QIs in clinical practice is needed to assess the correlation of performance on process QIs with performance on outcome QIs. (Inflamm Bowel Dis 2013;19:662-668)

引用

页码：662 / 668

页数：7

共 29 条

[1] ACOVE quality indicators [J].

不详 .

ANNALS OF INTERNAL MEDICINE, 2001, 135 (08) :653-667

[2]

Brook RH, 1994, CLIN PRACTICE GUIDEL

[3] Improved Outcomes in a Quality Improvement Collaborative for Pediatric Inflammatory Bowel Disease [J].

Crandall, Wallace V. ;

Margolis, Peter A. ;

Kappelman, Michael D. ;

King, Eileen C. ;

Pratt, Jesse M. ;

Boyle, Brendan M. ;

Duffy, Lynn F. ;

Grunow, John E. ;

Kim, Sandra C. ;

Leibowitz, Ian ;

Schoen, Bess T. ;

Colletti, Richard B. .

PEDIATRICS, 2012, 129 (04) :E1030-E1041

[4] Development of Process and Outcome Measures for Improvement: Lessons Learned in a Quality Improvement Collaborative for Pediatric Inflammatory Bowel Disease [J].

Crandall, Wallace V. ;

Boyle, Brendan M. ;

Colletti, Richard B. ;

Margolis, Peter A. ;

Kappelman, Michael D. .

INFLAMMATORY BOWEL DISEASES, 2011, 17 (10) :2184-2191

[5]

Donabedian A, 1992, QRB Qual Rev Bull, V18, P356

[6] HEALTH-RELATED QUALITY OF LIFE IN INFLAMMATORY BOWEL-DISEASE - FUNCTIONAL STATUS AND PATIENT WORRIES AND CONCERNS [J].

DROSSMAN, DA ;

PATRICK, DL ;

MITCHELL, CM ;

ZAGAMI, EA ;

APPELBAUM, MI .

DIGESTIVE DISEASES AND SCIENCES, 1989, 34 (09) :1379-1386

[7] Differences in the management of Crohn's disease among experts and community providers, based on a national survey of sample case vignettes [J].

Esrailian, E. ;

Spiegel, B. M. R. ;

Targownik, L. E. ;

Dubinsky, M. C. ;

Targan, S. R. ;

Gralnek, I. M. .

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2007, 26 (07) :1005-1018

[8]

Fitch SJB Kathryn, 2001, RAND UCLA APPROPRIAT

[9]

Kanwal F, CLIN GASTROENTEROL H, V8, P709

[10] Measuring Quality of Care in Patients With Nonvariceal Upper Gastrointestinal Hemorrhage: Development of an Explicit Quality Indicator Set [J].

Kanwal, Fasiha ;

Barkun, Alan ;

Gralnek, Ian M. ;

Asch, Steven M. ;

Kuipers, Ernst J. ;

Bardou, Marc ;

Sung, Joseph ;

Enns, Robert ;

Agreus, Lars ;

Armstrong, David ;

Spiegel, Brennan M. R. .

AMERICAN JOURNAL OF GASTROENTEROLOGY, 2010, 105 (08) :1710-1718

← 1 2 3 →