Fiche publication
Date publication
août 2010
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BARDOU Marc
Tous les auteurs :
Kanwal F, Barkun A, Gralnek IM, Asch SM, Kuipers EJ, Bardou M, Sung J, Enns R, Agreus L, Armstrong D, Spiegel BM
Lien Pubmed
Résumé
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 >or=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.
Référence
Am J Gastroenterol. 2010 Aug;105(8):1710-8.
