Gillespie F, Orsi G B, Caracci G, Scanzano P, Casertano L, Duranti G, Cardo S, Barone A P, Tozzi Q, Ammirati F
Dipartimento di Scienze di Sanità Pubblica G Sanarelli, Università degli Studi di Roma La Sapienza.
Ann Ig. 2007 Jan-Feb;19(1):63-71.
The objective of INCA project was the development and implementation of Acute Myocardial Infarction (AMI type ST elevation) process and outcome indicators for the regional cardiology units, testing the possibility of using regional healthcare information data to evaluate the quality of provided healthcare within the regional healthcare accreditation process. The project is introduced by an overview of major concepts of evaluating and managing quality of healthcare. We performed a literature review of structure, process and outcome indicators in cardiology and of accreditation standards for cardiology at national and international level. Through consensus procedures and according to international evidence based literature a set of 18 process and outcome indicators for AMI was defined. A specific procedure for data collection has been developed. Education and training of participants on procedures, quality and accreditation was achieved. Expected verifiable end-points have been achieved over a three months period of data collecting throughout 21 cardiology units, differentiated for level of complexity and location, for a total of 409 clinical observed cases of AMI. Analysis of data was followed by the diffusion of results. Successful data collection of clinical performance indicators on a regional basis was achieved. Participants have been trained to quality sciences. Results will be useful to evaluate and design implementation strategies of regional accreditation of health care services within a shared framework. Benchmarking within Regional hospital cardiology care services will be developed following self evaluation and continuous quality improvement cycle activities.
INCA项目的目标是为地区心脏病学单位制定并实施急性心肌梗死(ST段抬高型AMI)的过程和结果指标,测试利用地区医疗信息数据在地区医疗认证过程中评估所提供医疗服务质量的可能性。该项目以医疗服务质量评估和管理的主要概念概述作为开篇。我们对心脏病学领域的结构、过程和结果指标以及国家和国际层面的心脏病学认证标准进行了文献综述。通过共识程序并依据国际循证文献,定义了一套18项急性心肌梗死的过程和结果指标。制定了特定的数据收集程序。对参与者进行了关于程序、质量和认证方面的教育与培训。在为期三个月的数据收集期间,在21个心脏病学单位(根据复杂程度和地点进行区分)共观察了409例急性心肌梗死临床病例,实现了预期的可验证终点。在数据分析之后进行了结果传播。在地区层面成功收集了临床绩效指标数据。参与者接受了质量科学方面的培训。研究结果将有助于在共享框架内评估和设计地区医疗服务认证的实施策略。在自我评估和持续质量改进循环活动之后,将开展地区医院心脏病学护理服务的基准对比。