Angelici Laura, Angioletti Carmen, Pinnarelli Luigi, Colais Paola, de Mattia Egidio, Agabiti Nera, Davoli Marina, Acampora Anna
Department of Epidemiology, Regional Health Service-Lazio, Via Cristoforo Colombo, 112, 00147 Rome, Italy.
Management and Health Laboratory, Institute of Management, Department Embeds, Sant'Anna School of Advanced Studies, 56127 Pisa, Italy.
Healthcare (Basel). 2023 Jun 5;11(11):1651. doi: 10.3390/healthcare11111651.
Within the EASY-NET network program (NET-2016-02364191), Work Package 1 Lazio evaluates the effectiveness of a structured audit and feedback (A&F) intervention compared with the web-based regional periodic publication of indicators in improving the appropriateness and timeliness of emergency healthcare for acute myocardial infarction (AMI). This work describes the A&F methodology and presents the results of the first feedback delivered. The intervention involves sending periodic reports via e-mail to participating hospitals. The feedback reports include a set of volume and quality (process and outcome) indicators, calculated by facility through the health information system of the Lazio Region and compared with regional mean, target values and values calculated for hospitals with similar volumes of activity. Health managers and clinicians of each participating hospital represent the "feedback recipients". They are invited to organize clinical and organizational audit meetings to identify possible critical issues in the care pathway and define, where necessary, improvement actions. A total of 16 facilities are involved. Twelve facilities present high volumes in all volume indicators, while three facilities present low volumes for each indicator. Concerning the quality indicators, four facilities do not present critical indicators or had average results, three facilities do not present critical indicators but show average results in at least one of the indicators and six facilities present a critical value for at least one of the indicators. The first report highlighted some critical issues in some facilities on several indicators. During the audit meetings, each facility analyzes these issues, defining appropriate improvement actions. The outcome of these actions will be monitored through subsequent reporting to support the continuous care quality improvement process.
在EASY-NET网络项目（NET-2016-02364191）中，工作包1拉齐奥评估了结构化审核与反馈（A&F）干预措施相较于基于网络的区域定期发布指标，在提高急性心肌梗死（AMI）紧急医疗的适宜性和及时性方面的有效性。这项工作描述了A&F方法，并展示了首次反馈的结果。该干预措施包括通过电子邮件向参与的医院发送定期报告。反馈报告包括一组数量和质量（过程和结果）指标，这些指标由各机构通过拉齐奥地区的健康信息系统计算得出，并与区域平均值、目标值以及活动量相似的医院计算出的值进行比较。每个参与医院的卫生管理人员和临床医生是“反馈接收者”。他们被邀请组织临床和组织审核会议，以确定护理路径中可能存在的关键问题，并在必要时确定改进措施。共有16个机构参与其中。12个机构在所有数量指标上表现出高数值，而3个机构在每个指标上表现出低数值。关于质量指标，4个机构没有关键指标或结果为平均水平，3个机构没有关键指标，但在至少一个指标上显示出平均结果，6个机构在至少一个指标上呈现出临界值。第一份报告突出了一些机构在几个指标上存在的一些关键问题。在审核会议期间，每个机构分析这些问题，确定适当的改进措施。这些措施的结果将通过后续报告进行监测，以支持持续的护理质量改进过程。
