[Prioritization of performance measures for assessment of hospital-based stroke care quality through a consensus method].

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.