Standards of care and quality indicators for multidisciplinary care models for psoriatic arthritis in Spain

Gratacós, Jordi; Luelmo, Jesús; Rodríguez, Jesús; Notario, J.; Marco, Teresa Navío; Cueva, Pablo de la; Busquets, Manel Pujol; Font, Mercè García; Joven, Beatriz; Rivera, R.; Vega, Jose Luis Alvarez; Álvarez, A.J. Chaves; Parera, Ricardo Sánchez; Carrascosa, Jose Carlos Ruiz; Martínez, F.; Sánchez, José Pardo; Olmos, C. Feced; Pujol, C.; Galíndez, E.; Barrio, Santiago; Arana, A.; Hergueta, Mercedes; Coto, Pablo; Queiró, Rubén

doi:10.1007/s00296-018-3986-4

Cited by 15 publications

(19 citation statements)

References 33 publications

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“…The initiatives developed to date have focused on some specific aspects to improve the quality of care for patients with PsA. Examples of these improvements include assuring multidisciplinary care [ 12 ], the incorporation of patient-reported outcome measures (GRAPPA-OMERACT) [ 13 , 14 ], introducing structural, process and outcome indicators [ 6 ], progress in biological treatments and the evaluation of their results (MERECES study) [ 15 , 16 ]. However, no approach has been identified that focuses on the clinical management of the PsA units, ensuring the cycle of improvement in both care quality and patient safety.…”

Section: Discussionmentioning

confidence: 99%

“…The quality standards proposed by the NEXUS project [ 6 ] or the European League Against Rheumatism (EULAR) [ 7 ] recommendations have sought to promote integrated care by the multidisciplinary teams that intervene in PsA [ 8 , 9 ], and they have been oriented towards improving the quality of healthcare received by these patients, establishing a metric and recommendations for achieving optimal quality of care.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating standards of care in psoriatic arthritis of the QUANTUM project (qualitative initiative to improve outcomes): results of an accreditation project in Spain

et al. 2020

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In Spain, the QUANTUM project has been promoted to reduce variability in clinical practice and improve the care and quality of life of people with psoriatic arthritis (PsA) by accrediting PsA units throughout the Spanish national health system. To present the results of this approach which sought to ensure an optimum level of quality for patients with PsA. Descriptive analysis of the self-assessments that the PsA units have carried out assessing their degree of compliance with the quality standards established in the QUANTUM project grouped into four blocks: shortening time to diagnosis; optimizing disease management; improving multidisciplinary collaboration; and improving patient monitoring. A total of 41 PsA units were self-evaluated. They met 64.1% of the defined quality standards. Optimize disease management obtained a higher level of standards compliance (72%) and improve multidisciplinary collaboration the lesser (63.9%). Accessibility to the treatments available for PsA in all hospitals was guaranteed (100%). Appropriate diagnostic equipment is available (97.6%). Compliance with specific quality standards leads to detect actions that should be implemented: quality of life assessment (9.8%), locomotor system assessment (12.2%), physical examination data record (14.6%), periodic cardiovascular risk assessment (17.1%). The QUANTUM project results make it possible to visualise how to care for patients with PsA is being developed in Spain. Problems identified in recent multinational reports are also identified in Spain.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluating standards of care in psoriatic arthritis of the QUANTUM project (qualitative initiative to improve outcomes): results of an accreditation project in Spain

et al. 2020

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“…The literature search was updated in March 2019. Eighty-one new publications were identified, of which three described QIs or quality measures for different managements of rheumatoid arthritis and osteoarthritis [16], psoriatic arthritis [17] and inflammatory arthritis [18]. One paper described human rights based indicator framework systems to assess countries´ efforts to strengthen rehabilitation provision and policy [22].…”

Section: Methodsmentioning

confidence: 99%

A quality indicator set for use in rehabilitation team care of people with rheumatic and musculoskeletal diseases; development and pilot testing

Johansen

Klokkerud

Anke

et al. 2019

BMC Health Serv Res

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Background Systems for monitoring effectiveness and quality of rehabilitation services across health care levels are needed. The purpose of this study was to develop and pilot test a quality indicator set for rehabilitation of rheumatic and musculoskeletal diseases. Methods The set was developed according to the Rand/UCLA Appropriateness Method, which integrates evidence review, in-person multidisciplinary expert panel meetings and repeated anonymous ratings for consensus building. The quality indicators were pilot-tested for overall face validity and feasibility in 15 specialist and 14 primary care rehabilitation units. Pass rates (percentages of “yes”) of the indicators were recorded in telephone interviews with 29 unit managers (structure indicators), and 164 patients (process and outcome indicators). Time use and participants’ numeric rating of face validity (0–10, 10 = high validity) were recorded. Results Nineteen structure, 12 process and five outcome indicators were developed and piloted. Mean (range) sum pass rates for the structure, process and outcome indicators were 59%(84%), 66%(100%) and 84%(100%), respectively. Mean (range) face validity score for managers/patients was 8.3 (8)/7.9 (9), and mean answering time was 6.0/5.5 min. The final indicator set consists of 19 structure, 11 process and three outcome indicators. Conclusion To our knowledge this is the first quality indicator set developed for rehabilitation of rheumatic and musculoskeletal diseases. Good overall face validity and a feasible format indicate a set suitable for monitoring quality in rehabilitation. The variation in pass rates between centers indicates a potential for quality improvement in rheumatic and musculoskeletal rehabilitation in Norway. Electronic supplementary material The online version of this article (10.1186/s12913-019-4091-4) contains supplementary material, which is available to authorized users.

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“…The structure and process quality indicators reaching a final consensus included: defining MD model objectives and referral criteria; establishing a team composition and responsibilities; clinic workflow scheme and data collection; medical reports. 44 Similar initiatives have been conducted for IBD MD care units, 45,46 but focused on collaboration between surgeons, endoscopists, radiologists and…”

Section: Audit and Standards Of Care Of MD Working In Spamentioning

confidence: 99%

“…23 Likewise, only one of the initiatives of recommendations for MD working in SpA has included patients’ input in the process. 44 Whilst all MD care models described above claim to be patient centred, the patient does not play an active role in any of the models. Further work should be undertaken to improve this limitation, as the current studies might not capture patients’ needs and expectations.…”

Section: Challenges Of MD In Spa and Research Agendamentioning

confidence: 99%

Multidisciplinary working in the management of axial and peripheral spondyloarthritis

Gudu

Jadon

2020

Therapeutic Advances in Musculoskeletal

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Multidisciplinary (MD) care is essential in the management of patients with spondyloarthritis (SpA) and is one of the main pillars of disease management and patient care. However, evidence supporting the effectiveness and benefits of this strategy in SpA is scarce. In this review we discuss the three types of MD care models: (i) combined clinics (MD units), including ‘face to face’, ‘parallel’ and ‘circuit approach’ clinics; (ii) MD team meetings; (iii) group consultations. The most frequently used model in SpA studies has been the ‘parallel’ combined clinic and usually encompasses a rheumatologist and another specialist, most commonly a dermatologist or a gastroenterologist, that work in tandem according to predefined referral criteria and treatment algorithms. MD working seems to improve the care of patients with SpA by a better identification and diagnosis of the disease, an earlier and more comprehensive treatment approach, and better outcomes for patients in terms of disease activity, physical function, quality of life and patient satisfaction. Nevertheless, challenges remain. Data on effectiveness and feasibility are scarce and are mostly derived from studies with design issues and often without a unidisciplinary care comparator arm. Although patient centricity is one of the core values of patient care and MD setting in SpA, the patient often does not play an active role in most of the MD settings studied or in common clinical practice. Further efforts should be made so that MD care reflects patients’ expectations and needs. Overcoming these limits will help to implement successfully SpA MD care in daily clinical practice and subsequently to achieve a higher quality of care for our patients.

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Standards of care and quality indicators for multidisciplinary care models for psoriatic arthritis in Spain

Cited by 15 publications

References 33 publications

Evaluating standards of care in psoriatic arthritis of the QUANTUM project (qualitative initiative to improve outcomes): results of an accreditation project in Spain

Evaluating standards of care in psoriatic arthritis of the QUANTUM project (qualitative initiative to improve outcomes): results of an accreditation project in Spain

A quality indicator set for use in rehabilitation team care of people with rheumatic and musculoskeletal diseases; development and pilot testing

Multidisciplinary working in the management of axial and peripheral spondyloarthritis

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