Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Faculty of Medicine, Nursing and Health Sciences Monash University, Melbourne, Vic, Australia.
Heart Lung Circ. 2023 Nov;32(11):1361-1368. doi: 10.1016/j.hlc.2023.09.013. Epub 2023 Oct 25.
Lack of service data for cardiac rehabilitation limits understanding of program delivery, benchmarking and quality improvement. This study aimed to describe current practices, management, utilisation and engagement with quality indicators in Australian programs.
Cardiac rehabilitation programs (n=396) were identified from national directories and networks. Program coordinators were surveyed on service data capture, management systems and adoption of published national quality indicators. Text responses were coded and classified. Logistic regression determined independent associates of the use of data for quality improvement.
A total of 319 (81%) coordinators completed the survey. Annual patient enrolments/programs were >200 (31.0%), 51-200 (46%) and ≤50 (23%). Most (79%) programs used an electronic system, alongside paper (63%) and/or another electronic system (19%), with 21% completely paper. While 84% knew of the national quality indicators, only 52% used them. Supplementary to patient care, data were used for reports to managers (57%) and funders (41%), to improve quality (56%), support funding (43%) and research (31%). Using data for quality improvement was more likely when enrolments where >200 (Odds ratio [OR] 3.83, 95% Confidence Interval [CI] 1.76-8.34) and less likely in Victoria (OR 0.24 95%, CI 0.08-0.77), New South Wales (OR 0.25 95%, CI 0.08-0.76) and Western Australia (OR 0.16 95%, CI 0.05-0.57).
The collection of service data for cardiac rehabilitation patient data and its justification is diverse, limiting our capacity to benchmark and drive clinical practice. The findings strengthen the case for a national low-burden approach to data capture for quality care.
心脏康复计划服务数据的缺乏限制了对项目实施、基准测试和质量改进的了解。本研究旨在描述澳大利亚项目中当前的实践、管理、利用和对质量指标的参与情况。
从国家目录和网络中确定心脏康复计划(n=396)。对服务数据采集、管理系统以及采用已发布的国家质量指标的情况对计划协调员进行了调查。对文本回复进行了编码和分类。逻辑回归确定了用于质量改进的数据使用的独立关联因素。
共有 319 名(81%)协调员完成了调查。每年的患者入组/计划数量>200 例(31.0%)、51-200 例(46%)和≤50 例(23%)。大多数(79%)计划使用电子系统,同时使用纸质系统(63%)和/或另一个电子系统(19%),21%完全使用纸质系统。虽然 84%的人知道国家质量指标,但只有 52%的人使用这些指标。除了患者护理之外,数据还用于向管理人员(57%)和资助者(41%)报告,以改善质量(56%)、支持资金(43%)和研究(31%)。当入组人数>200 时,使用数据进行质量改进的可能性更大(优势比 [OR] 3.83,95%置信区间 [CI] 1.76-8.34),而在维多利亚州(OR 0.24 95%CI 0.08-0.77)、新南威尔士州(OR 0.25 95%CI 0.08-0.76)和西澳大利亚州(OR 0.16 95%CI 0.05-0.57)则不太可能。
心脏康复患者数据的服务数据收集及其合理性各不相同,限制了我们进行基准测试和推动临床实践的能力。这些发现为采用全国性的低负担数据采集方法来提供高质量护理提供了有力依据。