PDF(Pubmed)
Abstract：
BACKGROUND: Hypertension, a chronic medical condition affecting millions of people worldwide, is a leading cause of cardiovascular diseases. A multidisciplinary approach is needed to reduce the burden of the disease, with general practitioners playing a vital role. Therefore, it is crucial that GPs provide high-quality care that is standardized and based on the most recent European guidelines. Quality indicators (QIs) can be used to assess the performance, outcomes, or processes of healthcare delivery and are critical in helping healthcare professionals identify areas of improvement and measure progress towards achieving desired health outcomes. However, QIs to evaluate the care of patients with hypertension in general practice have been studied to a limited extent. The aim of our study is to define quality indicators for hypertension in general practice that are extractable from the electronic health record (EHR) and can be used to evaluate and improve the quality of care for hypertensive patients in the general practice setting.
METHODS: We used a Rand-modified Delphi procedure. We extracted recommendations from European guidelines and assembled them into an online questionnaire. An initial scoring based on the SMART principle and extractability from the EHR was performed by panel members, these results were analyzed using a Median Likert score, prioritization and degree of consensus. A consensus meeting was set up in which all the recommendations were discussed, followed by a final validation round.
RESULTS: Our study extracted 115 recommendations. After analysis of the online questionnaire round and a consensus meeting round, 37 recommendations were accepted and 75 were excluded. Of these 37 recommendations, 9 were slightly modified and 4 were combined into 2 recommendations, resulting in a list of 35 recommendations. All recommendations of the final set were translated to QIs, made up of 7 QIs on screening, 6 QIs on diagnosis, 11 QIs on treatment, 5 QIs on outcome and 6 QIs on follow-up.
CONCLUSIONS: Our study resulted in a set of 35 QIs for hypertension in general practice. These QIs, tailored to the Belgian EHR, provide a robust foundation for automated audit and feedback and could substantially benefit other countries if adapted to their systems.
METHODS: We used a Rand-modified Delphi procedure. We extracted recommendations from European guidelines and assembled them into an online questionnaire. An initial scoring based on the SMART principle and extractability from the EHR was performed by panel members, these results were analyzed using a Median Likert score, prioritization and degree of consensus. A consensus meeting was set up in which all the recommendations were discussed, followed by a final validation round.
RESULTS: Our study extracted 115 recommendations. After analysis of the online questionnaire round and a consensus meeting round, 37 recommendations were accepted and 75 were excluded. Of these 37 recommendations, 9 were slightly modified and 4 were combined into 2 recommendations, resulting in a list of 35 recommendations. All recommendations of the final set were translated to QIs, made up of 7 QIs on screening, 6 QIs on diagnosis, 11 QIs on treatment, 5 QIs on outcome and 6 QIs on follow-up.
CONCLUSIONS: Our study resulted in a set of 35 QIs for hypertension in general practice. These QIs, tailored to the Belgian EHR, provide a robust foundation for automated audit and feedback and could substantially benefit other countries if adapted to their systems.
摘要：
背景：高血压，影响全世界数百万人的慢性疾病，是心血管疾病的主要原因。需要采取多学科的方法来减轻疾病的负担，全科医生起着至关重要的作用。因此,全科医生提供标准化且基于最新欧洲指南的高质量护理至关重要.质量指标(QIs)可用于评估绩效，结果，或医疗保健交付过程，并在帮助医疗保健专业人员确定改进领域和衡量实现预期健康结果的进展方面至关重要。然而,已经在有限的程度上研究了在一般实践中评估高血压患者护理的QIs。我们研究的目的是定义一般实践中高血压的质量指标，这些质量指标可从电子健康记录（EHR）中提取，可用于评估和提高一般实践中高血压患者的护理质量。
方法：我们使用了Rand修改的Delphi程序。我们从欧洲指南中提取了建议，并将其汇总到在线问卷中。小组成员进行了基于SMART原理和EHR可提取性的初始评分，这些结果使用李克特中位数评分进行分析，优先次序和共识程度。召开了一次协商一致的会议,讨论了所有的建议,然后是最后一轮验证。
结果：我们的研究提取了115条建议。在分析了在线问卷轮和共识会议轮之后，37项建议被接受，75项被排除。在这37项建议中，9个被稍微修改，4个被合并为2个建议，产生了35条建议。最后一组的所有建议都被翻译成合格证明，由7个QIs组成，6QIsondiagnosis,11个QIsontreatment,关于结果的5个QIs和关于后续行动的6个QIs。
结论：我们的研究在一般实践中得出了35个高血压的QIs。这些QIs,为比利时EHR量身定制，为自动审计和反馈提供坚实的基础，如果适应其他国家的系统，可以大大受益。
方法：我们使用了Rand修改的Delphi程序。我们从欧洲指南中提取了建议，并将其汇总到在线问卷中。小组成员进行了基于SMART原理和EHR可提取性的初始评分，这些结果使用李克特中位数评分进行分析，优先次序和共识程度。召开了一次协商一致的会议,讨论了所有的建议,然后是最后一轮验证。
结果：我们的研究提取了115条建议。在分析了在线问卷轮和共识会议轮之后，37项建议被接受，75项被排除。在这37项建议中，9个被稍微修改，4个被合并为2个建议，产生了35条建议。最后一组的所有建议都被翻译成合格证明，由7个QIs组成，6QIsondiagnosis,11个QIsontreatment,关于结果的5个QIs和关于后续行动的6个QIs。
结论：我们的研究在一般实践中得出了35个高血压的QIs。这些QIs,为比利时EHR量身定制，为自动审计和反馈提供坚实的基础，如果适应其他国家的系统，可以大大受益。
