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SP0235 How to Develop Quality Indicators
  1. A. Woolf
  1. Bone and Joint Research Group, Royal Cornwall Hospital, Truro, United Kingdom

Abstract

Over the last decade, patients with rheumatic diseases have seen a dramatic change in the possibilities for diagnosis and treatment. For RA this includes diagnosis, pharmacological and surgical treatment, and rehabilitation. For OA, new strategies for education and self-management and exercise programmes and optimized surgical treatment. These are reflected in numerous evidence-based guidelines and recommendations developed during the last 10 years but poor adherence to treatment guidelines and large variations in quality of care has been reported. A way to quantify health care quality is by use of validated health care quality indicators (HCQIs) which measure the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current best practice. HCQIs can be related to the structural characteristics of the health care system and providers, processes in how providers deliver care, or outcomes of health care. HCQIs may be developed from literature search, evidence-based guidelines, and expert opinion by scientific societies and health care organizations incorporating scientists, health care providers as well as patient representatives. They may improve quality of arthritis care by various mechanisms. Their usage may raise awareness among individual practitioners regarding gaps in their service. Governments and health care funders are increasingly rewarding clinicians for efficiency, quality and safety in health care, and therefore measurable aspects of health care structures, processes and outcomes are needed. In addition the public want to be able to make informed choices about the care they receive. The EUMUSC.NET project (www.eumusc.net) developed HCQIs for OA and RA to improve the health of EU citizens. The aim is to bridge the gap between evidence-based guidelines and clinical practice by developing patient-centred standards of care (SOC) and HCQIs to assess whether they are being delivered by the healthcare system. To develop the SOC existing guidelines for OA and RA were reviewed and the key components identified and deveopled into a set of standards of what care people should expect to receive. To develop HCQIs, an inventory of the quality and content of currently available sets of HCQIs for RA and OA was initially undertaken by a systematic literature review. Their contents were analysed and categorised according to the SOC developed within eumusc.net. To ensure comprehensvieness and appropriateness, an expert panel comprising of healthcare providers and patient representatives reviewed and added to the proposed HCQIs. A Delphi process was then used by email to rank the topics and an expert meeting to rephrase suggested HCQIs. Numerators and the denominators for each HCQI were defined. To ensure feasibility an audit process was undertaken by rheumatology units in six countries. The next step is to use these HCQI to benchmark care in countries across Europe to drive up quality and ensure equity.

Disclosure of Interest None declared

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