Department of Medicine, Queen's University, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, Canada.
Department of Medicine, Cumming School of Medicine, University of Calgary, Canada.
Semin Arthritis Rheum. 2022 Jun;54:152002. doi: 10.1016/j.semarthrit.2022.152002. Epub 2022 Mar 26.
The Rheumatoid Arthritis (RA) Quality of Care Survey (RAQCS) was developed to measure care quality according to a previously developed national RA quality improvement framework.
The development of the RAQCS occurred over 3 phases. First, the survey was developed by a team of healthcare providers, researchers, and two patient partners based on the existing national quality framework's 21 performance measures (PMs) and strategic objectives. Second, cognitive debriefing interviews were conducted with individuals living with RA to identify survey clarity, appropriateness of survey questions, and response options. Third, the survey was revised and distributed to participants recruited from Rheum4U (rheumatology longitudinal cohort). Results were tabulated and compared with a chart audit of participant medical records.
Fifty-three participants completed the RAQCS. High performance (i.e., ≥70% meeting PM) was observed for 13 of 20 PMs. Lower performance was seen for the remaining PMs, which included documentation of body mass index (BMI) and smoking status, discussion of physical activity goals, comorbidity management including risk assessments for cardiovascular health and fragility fractures and disease activity assessment. There was high agreement (≥70%) between the RAQCS and chart review for 9 of 20 PMs.
High agreement was observed between the RAQCS and chart review for selected PMs. The RAQCS may also be a valuable tool for quality improvement for measures where data are not usually available through other sources. Further testing of the RAQCS is needed to ascertain its reliability and validity as a patient self-reported tool to measure RA care quality.
类风湿关节炎（RA）护理质量调查（RAQCS）是根据先前制定的国家 RA 质量改进框架开发的，用于衡量护理质量。
RAQCS 的开发分为三个阶段。首先，由医疗保健提供者、研究人员和两名患者合作伙伴组成的团队根据现有的国家质量框架的 21 项绩效指标（PMs）和战略目标开发了该调查。其次，对患有 RA 的个体进行认知性访谈，以确定调查的清晰度、问题的适当性和回答选项。第三，对调查进行修订，并分发给 Rheum4U（风湿病纵向队列）招募的参与者。结果进行制表并与参与者病历的图表审核进行比较。
53 名参与者完成了 RAQCS。20 个 PM 中有 13 个达到了高绩效（即≥70%符合 PM）。其余 PM 的表现较低，包括体重指数（BMI）和吸烟状况的记录、物理活动目标的讨论、合并症管理，包括心血管健康和脆弱性骨折风险评估以及疾病活动评估。RAQCS 与图表审核在 20 个 PM 中有 9 个高度一致（≥70%）。
RAQCS 与图表审核在选定的 PM 中观察到高度一致。RAQCS 也可能是衡量通常无法通过其他来源获得的数据的措施的质量改进的有价值工具。需要进一步测试 RAQCS，以确定其作为衡量 RA 护理质量的患者自我报告工具的可靠性和有效性。
