The Carolinas Center for Medical Excellence, Cary, North Carolina 27518, USA.
J Palliat Med. 2010 Dec;13(12):1451-9. doi: 10.1089/jpm.2010.0238.
In 2008, the Centers for Medicare & Medicaid Services (CMS) required U.S. hospices to implement comprehensive quality improvement programs. CMS contracted with the Quality Improvement Organization in North and South Carolina to develop quality measures and instruments to assess hospice and palliative care quality.
To develop a set of quality measures, with complete specifications, and data collection tools for use by hospice and palliative care providers in quality improvement.
Quality measures were identified from: published literature, the National Quality Forum, CMS measures, the National Quality Measures Clearinghouse, and measures submitted by two national hospice organizations. Available data on the quality measures were gathered and pilot data were collected for measures with no available data. A Technical Expert Panel (TEP) rated quality measures on: importance, scientific soundness, feasibility and usability, using numeric scores for each dimension. Scores for quality measures were averaged across dimensions and across TEP members to identify measures for further development.
Of 174 measures identified, 88 were determined appropriate to the setting and were reviewed and rated by the TEP. Measures with overall scores ≥75th percentile (n = 23), measures with high importance scores (n = 7), measures for under-represented domains (n = 2), and process measures antecedent to TEP identified measures (n = 2), and were selected.
Specifications and data collection tools are available for 34 PEACE quality measures that were highly rated by experts in hospice and palliative care. Future research should assess the scientific soundness and responsiveness of these measures to quality improvement.
2008 年，医疗保险和医疗补助服务中心（CMS）要求美国临终关怀机构实施全面质量改进计划。CMS 与北卡罗来纳州和南卡罗来纳州的质量改进组织签订合同，制定质量措施和工具，以评估临终关怀和姑息治疗的质量。
制定一套质量措施，具有完整的规范和数据收集工具，供临终关怀和姑息治疗提供者在质量改进中使用。
质量措施来自：已发表的文献、国家质量论坛、CMS 措施、国家质量措施信息交换所和两个国家临终关怀组织提交的措施。收集了现有质量措施的数据，并为没有现有数据的措施收集了试点数据。技术专家小组（TEP）根据重要性、科学合理性、可行性和可用性，使用每个维度的数字分数对质量措施进行评分。质量措施的分数在维度和 TEP 成员之间平均，以确定进一步开发的措施。
在确定的 174 项措施中，有 88 项被认为适合该环境，并由 TEP 进行了审查和评分。总体得分≥第 75 百分位的措施（n=23）、重要性得分高的措施（n=7）、代表性不足的领域的措施（n=2）、以及 TEP 确定的措施（n=2）的措施被选中。
PEACE 质量措施有 34 项具有高度专家评分，具有规范和数据收集工具。未来的研究应该评估这些措施在质量改进方面的科学合理性和反应性。
