先天性心脏病青少年及青年患者转归与过渡质量指标的制定。
Development of quality indicators of transfer and transition in adolescents and young adults with congenital heart disease.
机构信息
Center of Congenital Heart Disease, Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, 3010, Switzerland.
Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium.
出版信息
BMC Health Serv Res. 2023 Oct 25;23(1):1154. doi: 10.1186/s12913-023-10183-6.
BACKGROUND
Quality indicators are crucial in evaluating and comparing the quality of healthcare services. In the case of congenital heart disease, transition programmes for adolescents have been recommended to ensure uninterrupted healthcare and lifelong care. It is necessary to establish quality indicators in order to facilitate the evaluation of programme quality and to allow comparison between different centres. The objective of this study is therefore to develop a set of quality indicators for the transition of adolescents with congenital heart disease.
METHODS
The RAND/UCLA appropriateness method was employed in a four-step process to develop a set of quality indicators. First, a literature search was conducted on the dimensions of transitional care, based on which a preliminary set of quality indicators was developed. Second, experts were contacted, and an expert panel was established. Third, the panel members were asked to rate the appropriateness of the quality indicators in a two-round process. Finally, in the fourth step, we evaluated the data by measuring the median and Disagreement Index.
RESULTS
The expert panel consisted of 16 members, congenital cardiologists, nurses, transition experts, patients and research experts. The preliminary set of quality indicators comprised 16 items, categorized in process and structure criteria. Based on the panel's feedback, the set was refined to 12 quality indicators, which were rated as relevant and feasible.
CONCLUSIONS
This study represents the first attempt to develop quality indicators for transitional care services for adolescents with congenital heart disease. The set of 12 quality indicators was developed based on existing evidence and expert opinion. Further testing is needed to assess the feasibility of these quality indicators in daily practice. If successfully implemented, these quality indicators could allow comparison and facilitate benchmarking of transitional care services for adolescents with congenital heart disease.
背景
质量指标对于评估和比较医疗保健服务质量至关重要。在先天性心脏病的情况下，已经推荐为青少年设立过渡计划，以确保医疗服务的连续性和终身护理。为了便于评估计划质量并允许在不同中心之间进行比较，有必要制定质量指标。因此，本研究的目的是为患有先天性心脏病的青少年的过渡制定一套质量指标。
方法
采用 RAND/UCLA 适宜性方法，分四步制定了一套质量指标。首先，根据过渡护理的维度进行文献检索，在此基础上制定了初步的质量指标清单。其次，联系了专家，并成立了专家小组。第三，要求小组成员在两轮中对质量指标的适宜性进行评分。最后，在第四步中，通过测量中位数和分歧指数来评估数据。
结果
专家小组由 16 名成员组成，包括先天性心脏病专家、护士、过渡专家、患者和研究专家。初步的质量指标清单包括 16 项，分为过程和结构标准。根据小组的反馈，该清单被精简为 12 项质量指标，这些指标被认为是相关且可行的。
结论
本研究代表了首次尝试为患有先天性心脏病的青少年过渡护理服务制定质量指标。这 12 项质量指标是基于现有证据和专家意见制定的。需要进一步测试这些质量指标在日常实践中的可行性。如果成功实施，这些质量指标可以允许对青少年先天性心脏病的过渡护理服务进行比较和基准测试。
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