Measuring quality of care in patients with nonvariceal upper gastrointestinal hemorrhage: Development of an explicit quality indicator set
American Journal of Gastroenterology , Volume 105 - Issue 8 p. 1710- 1718
Objectives: With an increasing emphasis on quality in health care and recognition of inconsistencies in the management of patients with nonvariceal upper gastrointestinal hemorrhage (NVUGIH), it is critical to establish a set of explicit quality indicators (QIs) in NVUGIH. Methods: We conducted a nine-member, multidisciplinary expert panel and followed modified Delphi methods to systematically identify a set of QIs for NVUGIH. The panel performed independent ratings of each candidate QI using a nine-point RAND appropriateness scale, then met in person and re-voted using an iterative process of discussion. The final set comprised QIs with a median RAND Appropriateness Score 7 and no disagreement among experts. Results: Among 116 candidate QIs, the panel rated 26 as valid measures of quality care. The selected QIs cover pre-endoscopy, endoscopy, and post-endoscopy care, including diagnosis, early resuscitation, risk stratification, endoscopic care, Helicobacter pylori management, and proton pump inhibitor therapy. Conclusions: We have developed an explicit set of evidence-based QIs in NVUGIH, providing physicians and institutions with a tool to identify processes amenable to quality improvement. This tool is intended to be applicable in all institutions providing care for NVUGIH patients.
|Helicobacter infection, article, gastrointestinal endoscopy, health care quality, human, panel study, patient care, practice guideline, priority journal, proton pump inhibitor, resuscitation, risk assessment, upper gastrointestinal bleeding|
|American Journal of Gastroenterology|
|Organisation||Erasmus MC: University Medical Center Rotterdam|
Kanwal, F, Barkun, A.N, Gralnek, I.M, Asch, S.M, Kuipers, E.J, Bardou, M, … Spiegel, B.M.R. (2010). Measuring quality of care in patients with nonvariceal upper gastrointestinal hemorrhage: Development of an explicit quality indicator set. American Journal of Gastroenterology, 105(8), 1710–1718. doi:10.1038/ajg.2010.180