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Development of key performance indicators to evaluate centralized intake for patients with osteoarthritis and rheumatoid arthritis.

Barber CE, Patel JN, Woodhouse L, Smith C, Weiss S, Homik J, LeClercq S, Mosher D, Christiansen T, Howden JS, Wasylak T, Greenwood-Lee J, Emrick A, Suter E, Kathol B, Khodyakov D, Grant S, Campbell-Scherer D, Phillips L, Hendricks J, Marshall DA - Arthritis Res. Ther. (2015)

Bottom Line: Phase 1 involved stakeholder meetings including healthcare providers, managers, researchers and patients to obtain input on candidate KPIs, aligned along six quality dimensions: appropriateness, accessibility, acceptability, efficiency, effectiveness, and safety.All 28 KPIs were rated as valid and important.The KPIs measure five of the six dimensions of quality and are relevant to patients, practitioners and health systems.

View Article: PubMed Central - PubMed

Affiliation: Division of Rheumatology, Department of Medicine, University of Calgary, HRIC Room 3AA20, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada. cehbarbe@ucalgary.ca.

ABSTRACT

Introduction: Centralized intake is integral to healthcare systems to support timely access to appropriate health services. The aim of this study was to develop key performance indicators (KPIs) to evaluate centralized intake systems for patients with osteoarthritis (OA) and rheumatoid arthritis (RA).

Methods: Phase 1 involved stakeholder meetings including healthcare providers, managers, researchers and patients to obtain input on candidate KPIs, aligned along six quality dimensions: appropriateness, accessibility, acceptability, efficiency, effectiveness, and safety. Phase 2 involved literature reviews to ensure KPIs were based on best practices and harmonized with existing measures. Phase 3 involved a three-round, online modified Delphi panel to finalize the KPIs. The panel consisted of two rounds of rating and a round of online and in-person discussions. KPIs rated as valid and important (≥7 on a 9-point Likert scale) were included in the final set.

Results: Twenty-five KPIs identified and substantiated during Phases 1 and 2 were submitted to 27 panellists including healthcare providers, managers, researchers, and patients in Phase 3. After the in-person meeting, three KPIs were removed and six were suggested. The final set includes 9 OA KPIs, 10 RA KPIs and 9 relating to centralized intake processes for both conditions. All 28 KPIs were rated as valid and important.

Conclusions: Arthritis stakeholders have proposed 28 KPIs that should be used in quality improvement efforts when evaluating centralized intake for OA and RA. The KPIs measure five of the six dimensions of quality and are relevant to patients, practitioners and health systems.

No MeSH data available.


Related in: MedlinePlus

Example of a patient flow diagram for patients with osteoarthritis (OA) and patients with rheumatoid arthritis (RA) who are referred to centralized intake. Musculoskeletal (MSK) referral screening: clerical review of incoming referrals to quickly identify if referrals are complete, and which patients should be referred for a patient assessment to formally evaluate their MSK care needs. MSK referral triaging: review of screened referrals to establish urgency and prioritize patients for patient assessment based on disease and severity of symptoms. MSK Specialty Care: secondary care providers with MSK expertise, including specialists such as orthopaedic surgeons, rheumatologists, physiotherapists and nurses. MSK Specialist Care: subset of specialty care providers (i.e., specialized physicians, orthopaedic surgeons and rheumatologists). DMARD biologic and nonbiologic disease-modifying antirheumatic drug
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Fig2: Example of a patient flow diagram for patients with osteoarthritis (OA) and patients with rheumatoid arthritis (RA) who are referred to centralized intake. Musculoskeletal (MSK) referral screening: clerical review of incoming referrals to quickly identify if referrals are complete, and which patients should be referred for a patient assessment to formally evaluate their MSK care needs. MSK referral triaging: review of screened referrals to establish urgency and prioritize patients for patient assessment based on disease and severity of symptoms. MSK Specialty Care: secondary care providers with MSK expertise, including specialists such as orthopaedic surgeons, rheumatologists, physiotherapists and nurses. MSK Specialist Care: subset of specialty care providers (i.e., specialized physicians, orthopaedic surgeons and rheumatologists). DMARD biologic and nonbiologic disease-modifying antirheumatic drug

Mentions: The KPIs were selected to capture important steps along the continuum of care between referral submission to diagnosis and treatment (see Fig. 2). The stakeholders acknowledged that guidelines and high-quality evidence might be lacking for measurement of some of the candidate KPIs (e.g., measuring time from receipt of referral to completion, or measuring patient or provider experience with centralized intake). Therefore, professional consensus was deemed an acceptable level of evidence for development and inclusion of such candidate KPIs.Fig. 2


Development of key performance indicators to evaluate centralized intake for patients with osteoarthritis and rheumatoid arthritis.

Barber CE, Patel JN, Woodhouse L, Smith C, Weiss S, Homik J, LeClercq S, Mosher D, Christiansen T, Howden JS, Wasylak T, Greenwood-Lee J, Emrick A, Suter E, Kathol B, Khodyakov D, Grant S, Campbell-Scherer D, Phillips L, Hendricks J, Marshall DA - Arthritis Res. Ther. (2015)

Example of a patient flow diagram for patients with osteoarthritis (OA) and patients with rheumatoid arthritis (RA) who are referred to centralized intake. Musculoskeletal (MSK) referral screening: clerical review of incoming referrals to quickly identify if referrals are complete, and which patients should be referred for a patient assessment to formally evaluate their MSK care needs. MSK referral triaging: review of screened referrals to establish urgency and prioritize patients for patient assessment based on disease and severity of symptoms. MSK Specialty Care: secondary care providers with MSK expertise, including specialists such as orthopaedic surgeons, rheumatologists, physiotherapists and nurses. MSK Specialist Care: subset of specialty care providers (i.e., specialized physicians, orthopaedic surgeons and rheumatologists). DMARD biologic and nonbiologic disease-modifying antirheumatic drug
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4644283&req=5

Fig2: Example of a patient flow diagram for patients with osteoarthritis (OA) and patients with rheumatoid arthritis (RA) who are referred to centralized intake. Musculoskeletal (MSK) referral screening: clerical review of incoming referrals to quickly identify if referrals are complete, and which patients should be referred for a patient assessment to formally evaluate their MSK care needs. MSK referral triaging: review of screened referrals to establish urgency and prioritize patients for patient assessment based on disease and severity of symptoms. MSK Specialty Care: secondary care providers with MSK expertise, including specialists such as orthopaedic surgeons, rheumatologists, physiotherapists and nurses. MSK Specialist Care: subset of specialty care providers (i.e., specialized physicians, orthopaedic surgeons and rheumatologists). DMARD biologic and nonbiologic disease-modifying antirheumatic drug
Mentions: The KPIs were selected to capture important steps along the continuum of care between referral submission to diagnosis and treatment (see Fig. 2). The stakeholders acknowledged that guidelines and high-quality evidence might be lacking for measurement of some of the candidate KPIs (e.g., measuring time from receipt of referral to completion, or measuring patient or provider experience with centralized intake). Therefore, professional consensus was deemed an acceptable level of evidence for development and inclusion of such candidate KPIs.Fig. 2

Bottom Line: Phase 1 involved stakeholder meetings including healthcare providers, managers, researchers and patients to obtain input on candidate KPIs, aligned along six quality dimensions: appropriateness, accessibility, acceptability, efficiency, effectiveness, and safety.All 28 KPIs were rated as valid and important.The KPIs measure five of the six dimensions of quality and are relevant to patients, practitioners and health systems.

View Article: PubMed Central - PubMed

Affiliation: Division of Rheumatology, Department of Medicine, University of Calgary, HRIC Room 3AA20, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada. cehbarbe@ucalgary.ca.

ABSTRACT

Introduction: Centralized intake is integral to healthcare systems to support timely access to appropriate health services. The aim of this study was to develop key performance indicators (KPIs) to evaluate centralized intake systems for patients with osteoarthritis (OA) and rheumatoid arthritis (RA).

Methods: Phase 1 involved stakeholder meetings including healthcare providers, managers, researchers and patients to obtain input on candidate KPIs, aligned along six quality dimensions: appropriateness, accessibility, acceptability, efficiency, effectiveness, and safety. Phase 2 involved literature reviews to ensure KPIs were based on best practices and harmonized with existing measures. Phase 3 involved a three-round, online modified Delphi panel to finalize the KPIs. The panel consisted of two rounds of rating and a round of online and in-person discussions. KPIs rated as valid and important (≥7 on a 9-point Likert scale) were included in the final set.

Results: Twenty-five KPIs identified and substantiated during Phases 1 and 2 were submitted to 27 panellists including healthcare providers, managers, researchers, and patients in Phase 3. After the in-person meeting, three KPIs were removed and six were suggested. The final set includes 9 OA KPIs, 10 RA KPIs and 9 relating to centralized intake processes for both conditions. All 28 KPIs were rated as valid and important.

Conclusions: Arthritis stakeholders have proposed 28 KPIs that should be used in quality improvement efforts when evaluating centralized intake for OA and RA. The KPIs measure five of the six dimensions of quality and are relevant to patients, practitioners and health systems.

No MeSH data available.


Related in: MedlinePlus