Quality improvement in neurology: AAN epilepsy quality measures Report of the Quality Measurement and Reporting Subcommittee of the American Academy of Neurology
Quality improvement in neurology: AAN epilepsy quality measures Report of the Quality Measurement and Reporting Subcommittee of the American Academy of Neurology
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DOI：
10.1212/wnl.0b013e318203e9d1
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发表时间：
2011-01-04
期刊：
影响因子：
9.9
通讯作者：
Bever, C. T., Jr.
中科院分区：
文献类型：
--
作者：
Fountain, N. B.;Van Ness, P. C.;Bever, C. T., Jr.
目的：癫痫是一种常见的神经系统疾病，具有显著的个人，社会，医疗和经济负担。在提供的护理质量方面存在着相当大的差距。衡量所提供的护理质量是改善护理质量的第一步。绩效指标是一种易于识别和量化的方法，用于评估在患者就诊期间是否进行了特定活动。因此，癫痫性能的措施，通过一个标准化的系统化的过程，并可能是基础上的薪酬绩效的举措和维护的认证requirements.Methods：癫痫措施，通过美国医学会召开的医师联盟的性能改进（PCPI）的独立措施开发过程中，这标志着第一次医学专业社会遵循这一进程。使用一个框架对1998年至2008年期间使用国家指南交换中心、国家质量措施交换中心、PubMed、MEDLINE和科克伦图书馆审查的指南、措施和共识文件进行评价，以确定每个指南或其他证据审查文件对措施制定的可接受性。基于证据水平、重要性、有效性和护理差距的建议声明被开发为候选措施。一个由代表性组织组成的专家小组审查了这些措施。一段时间的公众意见，其次是批准从美国神经病学学会和PCPI.Results：文献检索确定了160个相关的建议声明，从19个指南和2个共识文件。系统评估产生了20项建议说明，专家小组将其细化为8项候选措施。这些措施是相关的癫痫发作的类型和频率，病因或癫痫综合征，脑电图，神经影像学，抗癫痫药物的副作用，安全问题，转介难治性癫痫，和问题的妇女生育potential.Conclusion：有一个合理的证据基础，共识，派生的性能措施，癫痫护理质量。预计这些绩效指标的实施将改善对癫痫患者的护理，如果提供者采用。神经病学（R）2011; 76：94-99
Objective: Epilepsy is a common neurologic condition with significant personal, societal, medical, and economic burdens. There are considerable gaps in the quality of care delivered. Measuring the quality of care delivered is the first step to its improvement. Performance measures are easily identified and quantitated ways to assess whether specific activities were carried out during a patient encounter. Therefore, epilepsy performance measures were derived through a standardized systematic process and may be the basis for pay-for-performance initiatives and maintenance of certification requirements.Methods: Epilepsy measures were developed through the American Medical Association-convened Physician Consortium for Performance Improvement (PCPI) independent measure development process, which marked the first time a medical specialty society followed this process. Guidelines, measures, and consensus papers reviewed for the period 1998 to 2008 using the National Guidelines Clearinghouse, the National Quality Measures Clearinghouse, PubMed, MEDLINE, and the Cochrane Library were evaluated using a framework to determine the acceptability of each guideline or other evidence review document for measures development. Recommendation statements based on level of evidence, importance, validity, and gap in care were developed into candidate measures. A panel of experts from representative organizations vetted the measures. A period of public comment was followed by approval from the American Academy of Neurology and the PCPI.Results: Literature search identified 160 relevant recommendation statements from 19 guidelines and 2 consensus papers. Systematic assessment resulted in 20 recommendation statements that were refined to 8 candidate measures by the expert panel. The measures are relevant to seizure type and frequency, etiology or epilepsy syndrome, EEG, neuroimaging, antiepileptic drug side effects, safety issues, referral for refractory epilepsy, and issues for women of childbearing potential.Conclusion: There is a reasonable evidence base, and consensus for, deriving performance measures for quality of epilepsy care. It is anticipated that implementation of these performance measures will improve care for patients with epilepsy if adopted by providers. Neurology (R) 2011; 76:94-99