Quality in the provision of headache care. 2: defining quality and its indicators
Quality in the provision of headache care. 2: defining quality and its indicators
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DOI：
10.1007/s10194-012-0465-2
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发表时间：
2012-08-01
影响因子：
7.4
通讯作者：
Steiner, Timothy
中科院分区：
文献类型：
--
作者：
Peters, Michele;Jenkinson, Crispin;Steiner, Timothy
本研究的目的是定义头痛护理的“质量”，并制定适用于不同环境和文化以及所有类型头痛的指标。头痛护理的质量没有明确的定义。在美国和英国提出的两套质量指标仅限于其所在地和/或特定于偏头痛，其开发没有收到头痛患者的输入。我们首先进行了文献综述。然后，我们与头痛护理的主要利益相关者（医生，护士和患者）进行了一系列焦点小组磋商。根据调查结果，我们提出了大量假定的质量指标，并在与更大的国际利益相关者代表团体的磋商中对这些指标进行了改进并减少了它们的数量。我们从质量指标中制定了质量的定义。确定了五个主题：（1）头痛服务;（2）卫生专业人员;（3）患者;（4）财政资源;（5）政治议程和立法。14个领域的160个假定质量指标的初步清单减少到9个领域的30个指标。这就产生了以下头痛护理质量的多维定义：“高质量的头痛护理实现准确的诊断和个性化的管理，有适当的转诊途径，教育患者关于他们的头痛和他们的管理，方便和舒适，满足患者，是有效和公平的，评估结果和安全。“头痛护理的质量是多方面的，存在于九个同等重要的基本领域。目前正在测试这些指标在临床环境中使用的可行性。
The objective of this study was to define "quality" of headache care, and develop indicators that are applicable in different settings and cultures and to all types of headache. No definition of quality of headache care has been formulated. Two sets of quality indicators, proposed in the US and UK, are limited to their localities and/or specific to migraine and their development received no input from people with headache. We first undertook a literature review. Then we conducted a series of focus-group consultations with key stakeholders (doctors, nurses and patients) in headache care. From the findings we proposed a large number of putative quality indicators, and refined these and reduced their number in consultations with larger international groups of stakeholder representatives. We formulated a definition of quality from the quality indicators. Five main themes were identified: (1) headache services; (2) health professionals; (3) patients; (4) financial resources; (5) political agenda and legislation. An initial list of 160 putative quality indicators in 14 domains was reduced to 30 indicators in 9 domains. These gave rise to the following multidimensional definition of quality of headache care: "Good-quality headache care achieves accurate diagnosis and individualized management, has appropriate referral pathways, educates patients about their headaches and their management, is convenient and comfortable, satisfies patients, is efficient and equitable, assesses outcomes and is safe." Quality in headache care is multidimensional and resides in nine essential domains that are of equal importance. The indicators are currently being tested for feasibility of use in clinical settings.