Development and implementation of evidence-based indicators for measuring quality of acute stroke care - The Quality Indicator Board of the German Stroke Registers Study Group (ADSR)

被引：120

作者：

Heuschmann, Peter U.

Biegler, Marcel K.

Busse, Otto

Elsner, Susanne

Grau, Armin

Hasenbein, Uwe

Hermanek, Peter

Janzen, Rudolf W. C.

Kolominisky-Rabas, Peter L.

Kraywinkel, Klaus

Lowitzsch, Klaus

Misselwitz, Bjoern

Nabavi, Darius G.

Otten, Kirsten

Pientka, Ludger

von Reutern, Gerhard M.

Ringelstein, Erich Bernd

Sander, Dirk

Wagner, Markus

Berger, Klaus

机构：

[1] Univ Munster, Inst Epidemiol & Soc Med, D-48149 Munster, Germany

[2] German Stroke Fdn, Guetersloh, Germany

[3] Univ Munich, Dept Neurol, D-80539 Munich, Germany

[4] Ruhr Univ Bochum, Dept Geriatr Med, Herne, Germany

[5] Stroke Register N Rhine, Dusseldorf, Germany

[6] Stroke Register Hesse, Eschborn, Germany

[7] Stroke Register Bavaria, Munich, Germany

[8] Univ Magdeburg, Neurol Inst Neurosurg Rehabil Res, D-39106 Magdeburg, Germany

[9] Stroke Register Baden Wuerttemberg, Stuttgart, Germany

[10] German Soc Neurol, Commiss Qual Management German Soc Neurol, Frankfurt, Germany

[11] Univ Erlangen Nurnberg, D-8520 Erlangen, Germany

[12] Univ Munster, Dept Neurol, D-4400 Munster, Germany

[13] Klinikum Stadt Ludwigshafen, Dept Neurol, D-6700 Ludwigshafen, Germany

[14] Inst Qual Hlth Care N Rhine, Dusseldorf, Germany

[15] Reg Off Qual Assurance Hesse, Eschborn, Germany

[16] Reg Off Qual Assurance Bavaria, Munich, Germany

[17] Reg Off Qual Assurance Baden Wuerttemberg, Stuttgart, Germany

[18] Unit Stroke Res & Publ Hlth Med, Nurnberg, Germany

[19] Commiss Hlth Care Res, Nurnberg, Germany

[20] German Stroke Soc, Nurnberg, Germany

[21] Commiss Stroke Unit & Acute Stroke Treatment, Munster, Germany

[22] German Stroke Soc, Munster, Germany

来源：

STROKE | 2006年 / 37卷 / 10期

关键词：

acute care; quality indicators; stroke;

D O I：

10.1161/01.STR.0000241086.92084.c0

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose-There is no consensus about indicators for measuring quality of acute stroke care in Germany. Therefore, a standardized process was initiated recently to develop and implement evidence-based indicators for the measurement of quality of acute hospital stroke care. Methods-Quality indicators were developed by a multidisciplinary board between November 2003 and December 2005. The process was initiated by the German Stroke Registers Study Group in cooperation with the German Stroke Society, the German Society of Neurology, the German Stroke Foundation, Regional Offices for Quality Assurance and other experts proven in the field. National and international recommendations were considered during the development process. The process was based on a systematic literature review, an independent external evaluation of the process and its results, and a prospective pilot study to evaluate the defined indicators in clinical practice. Results-Overall a set of 24 indicators was developed to measure performance of acute care hospitals in the 3 health care dimensions structure, process and outcome as well as in 3 treatment phases prehospital, in-hospital/acute and, postacute. Practicability of the derived indicators was tested in a prospective pilot study. During a 2-month period, 1006 patients in 13 hospitals were documented. Application of the new indicator set was found to be feasible by participating physicians and hospitals. Median time to document the required information for 1 patient was 5 minutes. Nationwide implementation of the new indicator set within regional registers in Germany started since April 2006. Conclusions-The development of indicators to measure hospital performance in stroke care is an important step toward improving stroke care on a national level. The chosen standardized evidence-based approach ensures maximal transparency, acceptance and sustainability of the developed indicators in Germany.

引用

页码：2573 / 2578

页数：6

共 24 条

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Guidelines for the Early Management of Patients With Ischemic Stroke - 2005 guidelines update - A scientific statement from the Stroke Council of the American Heart Association/American Stroke Association [J].