Serviço de Reumatologia, Centro Hospitalar Universitário de Lisboa Norte, Centro Académico de Medicina de Lisboa.
Serviço de Reumatologia, Centro Hospitalar Universitário de Lisboa Norte; Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Centro Académico de Medicina de Lisboa.
Acta Reumatol Port. 2021 Apr-Jun;46(2):140-155.
The Portuguese Rheumatology Society (SPR) embraced quality as a major goal and launched, in early 2015, a program to aim for excellence in global clinical care: Rheuma SPACE - Standard Practice Aiming Clinical Excellence. Evaluating daily reality is the first step in a quality development timeline, ultimately contributing for health gains. Herein we describe the results of the evaluation of the quality indicators defined for this project and the improvement strategies identified. The Rheuma SPACE project included three phases: 1) establishing a set of quality indicators and an excellence quality model; 2) assessment of the current care at Rheumatology departments concerning the defined quality indicators in the scope of the excellence model; and 3) elaboration of global and customized reports for each participating Rheumatology department, resulting in the identification of improvement opportunities. Ten Rheumatology departments, countrywide, including larger and smaller institutions, were asked to participate in Rheuma SPACE. This resulted in an individual report for each department along with global benchmarking practices analysis. Furthermore, a list of improvement initiatives was developed. We concluded that departments lack physicians and need exclusively dedicated nurses. Time dedicated to research and audit activities should be specifically allocated. Internal contracting is well established, and professionals are committed to targets. Processes are still suboptimal, needing standardization of triage criteria, more frequent follow-up, as well as better medical records and multidisciplinary coverage. Regarding outcomes, patients are satisfied with the provided care and professionals with the working environment. However, department facilities for the former, and career related aspects, for the latter should improve. With this innovative study conducted in Portugal we expect to have enlightened tailored opportunities for improvement, ensure patient-focused practices and be able to define the indispensable quality requirements for excellence.
葡萄牙风湿病学会（SPR）将质量作为主要目标，并于 2015 年初启动了一项旨在实现全球临床护理卓越的计划：Rheuma SPACE-临床卓越标准实践。评估日常实际情况是质量发展时间表的第一步，最终有助于提高健康水平。在此，我们描述了评估为该项目定义的质量指标的结果以及确定的改进策略。Rheuma SPACE 项目包括三个阶段：1）建立一套质量指标和卓越质量模型；2）评估风湿病科在卓越模型范围内针对定义的质量指标的当前护理情况；3）为每个参与的风湿病科制定全球和定制报告，从而确定改进机会。十个全国性的风湿病科，包括大、小机构，被要求参与 Rheuma SPACE。这为每个部门提供了一份单独的报告，并对全球基准实践进行了分析。此外，还制定了一份改进计划清单。我们得出的结论是，各部门缺乏医生，需要专门配备护士。应专门分配时间用于研究和审计活动。内部承包已得到很好的建立，专业人员致力于实现目标。流程仍不尽如人意，需要对分诊标准进行标准化，更频繁地进行随访，以及更好的病历和多学科覆盖。就结果而言，患者对提供的护理感到满意，专业人员对工作环境感到满意。然而，前者需要改善部门的设施，后者则需要改善与职业相关的方面。通过在葡萄牙进行这项创新性研究，我们希望能够为改进提供有针对性的机会，确保以患者为中心的实践，并能够确定卓越的必要质量要求。
