Grand Johannes, Schiele Francois, Hassager Christian, Nolan Jerry P, Khoury Abdo, Sionis Alessandro, Nikolaou Nikolaos, Donadello Katia, Behringer Wilhelm, Böttiger Bernd W, Combes Alain, Quinn Tom, Price Susanna, Jorge-Perez Pablo, Tavazzi Guido, Ristagno Giuseppe, Cariou Alain, Bonnefoy Cudraz Eric
Department of Cardiology, Amager-Hvidovre Hospital, University Hospital of Copenhagen, Copenhagen, Denmark.
Department of Cardiology, University Hospital of Copenhagen, Rigshospitalet, The Heart Center, Copenhagen, Denmark.
Eur Heart J Acute Cardiovasc Care. 2023 Apr 3;12(3):197-210. doi: 10.1093/ehjacc/zuad006.
Quality of care (QoC) is a fundamental tenet of modern healthcare and has become an important assessment tool for healthcare authorities, stakeholders and the public. However, QoC is difficult to measure and quantify because it is a multifactorial and multidimensional concept. Comparison of clinical institutions can be challenging when QoC is estimated solely based on clinical outcomes. Thus, measuring quality through quality indicators (QIs) can provide a foundation for quality assessment and has become widely used in this context. QIs for the evaluation of QoC in acute myocardial infarction are now well-established, but no such indicators exist for the process from resuscitation of cardiac arrest and post-resuscitation care in Europe.
The Association of Acute Cardiovascular Care of the European Society Cardiology, the European Resuscitation Council, European Society of Intensive Care Medicine and the European Society for Emergency Medicine, have reflected on the measurement of QoC in cardiac arrest. A set of QIs have been proposed, with the scope to unify and evolve QoC for the management of cardiac arrest across Europe.
We present here the list of QIs (6 primary QIs and 12 secondary Qis), with descriptions of the methodology used, scientific justification and motives for the choice for each measure with the aim that this set of QIs will enable assessment of the quality of postout-of-hospital cardiac arrest management across Europe.
医疗质量(QoC)是现代医疗保健的基本原则,已成为医疗保健当局、利益相关者和公众的重要评估工具。然而,由于QoC是一个多因素、多维度的概念,因此难以衡量和量化。仅根据临床结果评估QoC时,临床机构之间的比较可能具有挑战性。因此,通过质量指标(QIs)来衡量质量可为质量评估提供基础,并已在这方面得到广泛应用。目前,用于评估急性心肌梗死QoC的QIs已确立,但在欧洲,尚无用于心脏骤停复苏及复苏后护理过程的此类指标。
欧洲心脏病学会急性心血管护理协会、欧洲复苏委员会、欧洲重症监护医学学会和欧洲急诊医学学会,已对心脏骤停时QoC的测量进行了思考。已提出了一套QIs,旨在统一并改进整个欧洲心脏骤停管理的QoC。
我们在此列出了QIs清单(6个主要QIs和12个次要QIs),并对所使用的方法、科学依据以及每项指标选择的动机进行了描述,目的是使这套QIs能够评估整个欧洲院外心脏骤停管理的质量。