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Impact of a patient-specific co-designed COPD care scorecard on COPD care quality: a quasi-experimental study.

Roberts CM, Gungor G, Parker M, Craig J, Mountford J - NPJ Prim Care Respir Med (2015)

Bottom Line: We hypothesised that providing patients with individualised care quality data would drive improvements to the care received by those patients.Increases in the provision of self-management plans were seen in both the groups.No improvement was seen in other indicators.

View Article: PubMed Central - PubMed

Affiliation: Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

ABSTRACT

Background: The evidence that sharing mass care quality data with health service users improves care is weak.

Aims: We hypothesised that providing patients with individualised care quality data would drive improvements to the care received by those patients.

Methods: Together with patients who had chronic obstructive pulmonary disease (COPD), we co-designed a quality score card mapping indicators derived from National Institute for Clinical Excellence (NICE) quality standards against matched data taken from their general practice clinical records. All 640 COPD patients from 10 practices had improvements in these indicators before and 3 months after the intervention compared with 595 COPD patients in 10 control practices.

Results: Significant improvements in referral to pulmonary rehabilitation (P=0.03) and confirmation of diagnosis with spirometry (P=0.001) were seen in the intervention compared with the control practice population (P<0.001). Increases in the provision of self-management plans were seen in both the groups. No improvement was seen in other indicators.

Conclusions: Although the study is not able to prove a direct cause and effect, there is sufficient evidence presented to warrant the larger-scale evaluation of co-designed, personalised, quality score cards for COPD patients used as a tool to enhance care quality.

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Related in: MedlinePlus

Pages 2 and 3 of the personalised scorecard using traffic light system to indicate compliance with key NICE quality standards, accompanying explanation of the standard and its importance to the patient.
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fig1: Pages 2 and 3 of the personalised scorecard using traffic light system to indicate compliance with key NICE quality standards, accompanying explanation of the standard and its importance to the patient.

Mentions: The agreed scorecard consisted of a four-page A4-sized document. The front page contained the patient and GP details with a short explanation. The two-page middle section contained the six-item quality scorecard (Figure 1). For each item there was a brief explanation of what the item was, e.g., spirometry, why it was important to the care of patients with COPD, and the NICE standard itself. Alongside each standard was an indicator of the compliance with that standard using a traffic light system. The data used to assign the level of compliance was derived from the clinical record of that patient held by the GP surgery at which the patient was registered—green indicating full compliance, amber indicating partial compliance and red indicating the absence of confirmation that a standard had been reached. The amber coding would be used if there was evidence that an intervention was planned but had not yet completed; e.g., a patient was referred for advice to stop smoking but was still smoking at the time of the data upload, or a standard had been met in the past but had time-elapsed, e.g., annual review. The fourth, back, page listed the local medical services and contact numbers for the provision of urgent or emergency care for COPD patients in Redbridge.


Impact of a patient-specific co-designed COPD care scorecard on COPD care quality: a quasi-experimental study.

Roberts CM, Gungor G, Parker M, Craig J, Mountford J - NPJ Prim Care Respir Med (2015)

Pages 2 and 3 of the personalised scorecard using traffic light system to indicate compliance with key NICE quality standards, accompanying explanation of the standard and its importance to the patient.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4532153&req=5

fig1: Pages 2 and 3 of the personalised scorecard using traffic light system to indicate compliance with key NICE quality standards, accompanying explanation of the standard and its importance to the patient.
Mentions: The agreed scorecard consisted of a four-page A4-sized document. The front page contained the patient and GP details with a short explanation. The two-page middle section contained the six-item quality scorecard (Figure 1). For each item there was a brief explanation of what the item was, e.g., spirometry, why it was important to the care of patients with COPD, and the NICE standard itself. Alongside each standard was an indicator of the compliance with that standard using a traffic light system. The data used to assign the level of compliance was derived from the clinical record of that patient held by the GP surgery at which the patient was registered—green indicating full compliance, amber indicating partial compliance and red indicating the absence of confirmation that a standard had been reached. The amber coding would be used if there was evidence that an intervention was planned but had not yet completed; e.g., a patient was referred for advice to stop smoking but was still smoking at the time of the data upload, or a standard had been met in the past but had time-elapsed, e.g., annual review. The fourth, back, page listed the local medical services and contact numbers for the provision of urgent or emergency care for COPD patients in Redbridge.

Bottom Line: We hypothesised that providing patients with individualised care quality data would drive improvements to the care received by those patients.Increases in the provision of self-management plans were seen in both the groups.No improvement was seen in other indicators.

View Article: PubMed Central - PubMed

Affiliation: Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

ABSTRACT

Background: The evidence that sharing mass care quality data with health service users improves care is weak.

Aims: We hypothesised that providing patients with individualised care quality data would drive improvements to the care received by those patients.

Methods: Together with patients who had chronic obstructive pulmonary disease (COPD), we co-designed a quality score card mapping indicators derived from National Institute for Clinical Excellence (NICE) quality standards against matched data taken from their general practice clinical records. All 640 COPD patients from 10 practices had improvements in these indicators before and 3 months after the intervention compared with 595 COPD patients in 10 control practices.

Results: Significant improvements in referral to pulmonary rehabilitation (P=0.03) and confirmation of diagnosis with spirometry (P=0.001) were seen in the intervention compared with the control practice population (P<0.001). Increases in the provision of self-management plans were seen in both the groups. No improvement was seen in other indicators.

Conclusions: Although the study is not able to prove a direct cause and effect, there is sufficient evidence presented to warrant the larger-scale evaluation of co-designed, personalised, quality score cards for COPD patients used as a tool to enhance care quality.

Show MeSH
Related in: MedlinePlus