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Pablo L, Beckford CA, Martin-Delgado J, Ferro Osuna M, Fernández-Ferreiro A, Fernández Rodriguez MI, Rodriguez Cid MJ, Méndez S, Torres A, Ignacio E, Mira JJ. «Do Not Do» recommendations for retinopathies: A mixed consensus study. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:578-586. [PMID: 34756279 DOI: 10.1016/j.oftale.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/08/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Among the main causes of blindness and severe vision loss are age-related macular degeneration, diabetic macular oedema, and retinal vein occlusion. The «Do Not Do» recommendations are strategies to improve quality of care and optimise healthcare costs. The aim of this study was to establish, by consensus, practices of low value in the above-mentioned pathologies, in addition to estimating their occurrence. MATERIALS AND METHODS Mixed methods study including a first phase of consensus of a multidisciplinary panel of experts using the Nominal Group technique. In the second phase, a retrospective observational study was conducted, by conducting a review of medical records. RESULTS A total of 7 recommendations were established for age-related macular degeneration, 4 for diabetic macular oedema, and 5 for retinal vein occlusion. A total of 1,012 medical records were reviewed by the 4 participating hospitals. The review of medical records revealed that agreed «Do Not Do's» occurred in a range between 0.6% and 31.4% of the cases included in the study. CONCLUSIONS This study identified «Do Not Do» recommendations in these pathologies that occur relatively often in clinical practice. It is necessary to review the healthcare processes that will enable these practices to be eradicated, and the quality of care to be improved.
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Affiliation(s)
- L Pablo
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, Spain; OFTARED, Universidad de Zaragoza, Zaragoza, Spain
| | - C A Beckford
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares (Madrid), Spain
| | - J Martin-Delgado
- Grupo de Investigación ATENEA, Fundación para el Fomento de la Investigación Biomédica y Sanitaria, San Juan, Alicante, Spain.
| | - M Ferro Osuna
- Servicio de Oftalmología, Hospital 12 de Octubre, Madrid, Spain
| | - A Fernández-Ferreiro
- Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - M I Fernández Rodriguez
- Servicio de Oftalmología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Ophthalmology and Visual Sciences Research Group, Universidad de Santiago de Compostela, Santiago de Compostela, Spain; Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, Spain
| | - M J Rodriguez Cid
- Servicio de Oftalmología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Ophthalmology and Visual Sciences Research Group, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - S Méndez
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, Spain; OFTARED, Universidad de Zaragoza, Zaragoza, Spain
| | - A Torres
- Sociedad Española de Calidad Asistencial, Oviedo, Spain
| | | | - J J Mira
- Grupo de Investigación ATENEA, Fundación para el Fomento de la Investigación Biomédica y Sanitaria, San Juan, Alicante, Spain; Departamento de Salud Alicante-Sant Joan, Alicante, Spain; Universidad Miguel Hernández, Elche (Alicante), Spain
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Pablo L, Beckford CA, Martin-Delgado J, Ferro Osuna M, Fernández-Ferreiro A, Fernández Rodriguez MI, Rodríguez Cid MJ, Méndez S, Torres A, Ignacio E, Mira JJ. «Do Not Do» recommendations for retinopathies: A mixed consensus study. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:S0365-6691(21)00034-4. [PMID: 33612365 DOI: 10.1016/j.oftal.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/31/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Among the main causes of blindness and severe vision loss are age-related macular degeneration, diabetic macular oedema, and retinal vein occlusion. The «Do Not Do» recommendations are strategies to improve quality of care and optimise healthcare costs. The aim of this study was to establish, by consensus, practices of low value in the above-mentioned pathologies, in addition to estimating their occurrence. MATERIALS AND METHODS Mixed methods study including a first phase of consensus of a multidisciplinary panel of experts using the Nominal Group technique. In the second phase, a retrospective observational study was conducted, by conducting a review of medical records. RESULTS A total of 7 recommendations were established for age-related macular degeneration, 4 for diabetic macular oedema, and 5 for retinal vein occlusion. A total of 1,012 medical records were reviewed by the 4 participating hospitals. The review of medical records revealed that agreed «Do Not Do's» occurred in a range between 0.6% and 31.4% of the cases included in the study. CONCLUSIONS This study identified «Do Not Do» recommendations in these pathologies that occur relatively often in clinical practice. It is necessary to review the healthcare processes that will enable these practices to be eradicated, and the quality of care to be improved.
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Affiliation(s)
- L Pablo
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; OFTARED, Universidad de Zaragoza, Zaragoza, España
| | - C A Beckford
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares (Madrid), España
| | - J Martin-Delgado
- Grupo de Investigación ATENEA, Fundación para el Fomento de la Investigación Biomédica y Sanitaria, San Juan, Alicante , España.
| | - M Ferro Osuna
- Servicio de Oftalmología, Hospital 12 de Octubre, Madrid, España
| | - A Fernández-Ferreiro
- Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS) , Santiago de Compostela, España; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, España
| | - M I Fernández Rodriguez
- Servicio de Oftalmología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España; Ophthalmology and Visual Sciences Research Group, Universidad de Santiago de Compostela, Santiago de Compostela, España; Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, España
| | - M J Rodríguez Cid
- Servicio de Oftalmología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España; Ophthalmology and Visual Sciences Research Group, Universidad de Santiago de Compostela, Santiago de Compostela, España
| | - S Méndez
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; OFTARED, Universidad de Zaragoza, Zaragoza, España
| | - A Torres
- Sociedad Española de Calidad Asistencial, Oviedo, España
| | - E Ignacio
- Universidad de Cádiz, Cádiz, Espa0ña
| | - J J Mira
- Grupo de Investigación ATENEA, Fundación para el Fomento de la Investigación Biomédica y Sanitaria, San Juan, Alicante , España; Departamento de Salud Alicante-Sant Joan, Alicante, España; Universidad Miguel Hernández, Elche (Alicante), España
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Zamora-Soler JÁ, Maturana-Ibáñez V, Castejón-de la Encina ME, García-Aracil N, Lillo-Crespo M. Implementation of health care quality indicators for out-of-hospital emergencies: a systematic review. Emergencias 2019; 31:346-352. [PMID: 31625307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Although many health care quality indicators have been defined for establishing a common, homogeneous, and reliable system for assessing emergency department care, less information is available on the use of indicators of quality in attending emergencies outside the hospital. We aimed to identify and analyze quality indicators that have appeared in the literature on out-of-hospital emergencies. This systematic review of the literature followed the ations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We developed protocols for searching 5 databases to locate studies using quality indicators to evaluate care in out-of-hospital emergencies. Studies were published between July 2017 and July 2018 in either English or Spanish. We identified 22 studies naming 333 quality indicators in out-of-hospital emergencies. The indicators were classified as clinical or nonclinical; within each of these 2 sets, we also identified domains, or subcategories. As nonclinical quality identifiers were more numerous in the literature, it seems that they are the ones most often used to assess out-of-hospital emergency care at this time. This finding leaves the door open to designing and implementing new indicators able to measure quality of care in this clinical setting.
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Affiliation(s)
- José Ángel Zamora-Soler
- Servicio de Emergencias Sanitarias de Alicante, Alicante, España. Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Alicante, Alicante, España
| | - Vanesa Maturana-Ibáñez
- Servicio de Cirugía General y Aparato Digestivo, Hospital General Universitario de Elda, Alicante, España
| | - María Elena Castejón-de la Encina
- Servicio de Emergencias Sanitarias de Alicante, Alicante, España. Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Alicante, Alicante, España
| | - Noelia García-Aracil
- Servicio de Emergencias Sanitarias de Alicante, Alicante, España. Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Alicante, Alicante, España
| | - Manuel Lillo-Crespo
- Dirección de Enfermería, Clínica HLA Vistahermosa, Alicante, España. Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Alicante, Alicante, España
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