Systematic and progressive implementation of the centers of excellence for rheumatoid arthritis: a methodological proposal

Santos-Moreno, P.; Caballero-Uribe, Carlo V.; Massardo, Maria Loreto; Galarza-Maldonado, Claudio; Soriano, Enrique R.; Pineda, Carlos; Cardiel, Mario H.; Benavides, J. A.; Beltrán, Paula Andrea

doi:10.1007/s10067-017-3790-7

Cited by 7 publications

(8 citation statements)

References 9 publications

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“…8,9 Also, a team of healthcare-related professionals should deliver such an integrated care model with a multidisciplinary approach, within an environment of quality, opportunity, accessibility, and safety. 1,2,10 In Colombia, the healthcare system operates through a mixed public-private model regulated by the Ministry of Health. This system covers 94.6% of the population and includes benefits for high-cost diseases including rheumatoid arthritis for diagnosis, treatment and the access to biological drugs if it is required.…”

Section: Introductionmentioning

confidence: 99%

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<p>Clinical Outcomes of Patients with Rheumatoid Arthritis Treated in a Disease Management Program: Real-World Results</p>

Santos-Moreno¹,

Castillo²,

Villareal³

et al. 2020

OARRR

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Background: Care models can affect the clinical outcome of patients with rheumatic and musculoskeletal diseases. Objective: We aimed to compare how an innovative model of a rheumatoid arthritis disease-management program can improve the clinical outcomes of patients compared to a conventional assessment approach. Methods: We performed a retrospective analysis of real-world data from clinical records of a cohort of 5078 patients diagnosed with rheumatoid arthritis who were followed up at the Center of Excellence in Rheumatoid Arthritis vs the clinical outcomes reported in the Colombian National Registry of Rheumatoid Arthritis. Results: We found significant differences in the diagnosis and follow-up between the specialized Center program and the usual care reported by the Colombian National Registry (p<0.005), including the evaluation of rheumatoid factor, Anti-citrullinated antibodies Disease Activity Score, Health Assessment Questionnaire, number of visits to the rheumatologist, and clinical outcomes measured by the level of disease activity. In addition, when comparing the Center's clinical outcomes-from baseline to the last follow-up, we found an improvement in the level of disease activity, with patients classified in remission increasing from 20.8% to 58.5% (p<0.005), and a reduction in those with high disease activity from 18% to 4.7% (p<0.005). Conclusion: Real-world evidence showed that patients with rheumatoid arthritis who underwent follow-up under an innovative disease-management model improved their clinical outcomes compared with those patients in a conventional assessment program. These results could suggest a way of improving health policies for patients with rheumatoid arthritis.

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Section: Introductionmentioning

confidence: 99%

“…Also, a team of healthcare-related professionals should deliver such an integrated care model with a multidisciplinary approach, within an environment of quality, opportunity, accessibility, and safety. 1 , 2 , 10 …”

Section: Introductionmentioning

confidence: 99%

<p>Clinical Outcomes of Patients with Rheumatoid Arthritis Treated in a Disease Management Program: Real-World Results</p>

Santos-Moreno¹,

Castillo²,

Villareal³

et al. 2020

OARRR

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“…Santos-Moreno et al (36) employed the REAL-PANLAR Group model as a requirement for implementation and accreditation of COEs in rheumatoid arthritis care. The framework defined three types of CoEs based on structure, process, and outcome indicators - standard, optimal, and model.…”

Section: Resultsmentioning

confidence: 99%

“…It has been shaping institutions with ways to consolidate and build on their expertise and develop the capacity for scientific and financial gains (6). Organizations that work under the COE model have been maximizing the performance of their teams and nurturing productivity (7).…”

Section: Introductionmentioning

confidence: 99%

Conceptualizing centers of excellence: A global evidence

Manyazewal

Woldeamanuel

Oppenheim

et al. 2021

Preprint

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ObjectiveGlobally, interest in excellence has grown exponentially, with public and private institutions shifting their attention from meet targets to achieving excellence. Centers of Excellence (CoEs) are standing at the forefront of healthcare, research, and innovations responding to the world’s most complex problems. However, their potential is hindered by conceptual ambiguity. We conducted a global synthesis of the evidence to conceptualize CoEs.DesignScoping review, following Arksey and O’Malley’s framework and methodological enhancement by Levac et al to analyze the evidence and the PRISMA-ScR to guide the retrieval and inclusion of the evidence.Data sourcesPubMed, Scopus, CINAHL, Google Scholar, and the Google engine from their inception to 01 January 2021.EligibilityPapers that describe CoE as the main theme, which could be defining, theorizing, implementing, or evaluating a CoE.ResultsThe search resulted in 52,161 potential publications, with 78 articles met the eligibility criteria. The 78 articles were from 33 countries, of which 35 were from the United States of America, 3 each from Nigeria, South Africa, Spain, and India, and 2 each from Ethiopia, Canada, Russia, Colombia, Sweden, Greece, and Peru. The rest 17 were from various countries. The articles involved six thematic areas - healthcare, education, research, industry, information technology, and general concepts on CoE. The analysis documented success stories of using the brand “Center of Excellence” - an influential brand to stimulate technical skills, innovation, and technology. We identified 12 essential foundations of CoE - specialized expertise; infrastructure; innovation; high-impact research; quality service; accreditation or standards; leadership; organizational structure; strategy; collaboration and partnership; sustainable funding or financial mechanisms; and entrepreneurship.ConclusionsCoEs have significant scientific, political, economic, and social impacts. A comprehensive framework is needed to guide and inspire an institution as a CoE and to help government and funding institutions shape and oversee CoEs.Strengths and limitations of this study-To the best of our knowledge, this is the first scoping review to conceptualize centers of excellence based on global evidence.-The study followed Arksey and O’Malley’s framework and methodological enhancement by Levac et al to and the PRISMA-ScR methodological frameworks.-Five databases were systematically searched to identify scientific and gray literature-The study was limited by language restrictions.

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“…Santos-Moreno et al 7 employed the REAL-PANLAR Group model as a requirement for implementation and accreditation of CoEs in rheumatoid arthritis care. The framework defined three types of CoEs based on structure, process, and outcome indicators-standard, optimal and model.…”

Section: Framework and Models Of Coementioning

confidence: 99%

Conceptualising centres of excellence: a scoping review of global evidence

et al. 2022

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ObjectiveGlobally, interest in excellence has grown exponentially, with public and private institutions shifting their attention from meeting targets to achieving excellence. Centres of Excellence (CoEs) are standing at the forefront of healthcare, research and innovations responding to the world’s most complex problems. However, their potential is hindered by conceptual ambiguity. We conducted a global synthesis of the evidence to conceptualise CoEs.DesignScoping review, following Arksey and O’Malley’s framework and methodological enhancement by Levac et al and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.Data sourcesPubMed, Scopus, CINAHL, Google Scholar and the Google engine until 1 January 2021.EligibilityArticles that describe CoE as the main theme.ResultsThe search resulted in 52 161 potential publications, with 78 articles met the eligibility criteria. The 78 articles were from 33 countries, of which 35 were from the USA, 3 each from Nigeria, South Africa, Spain and India, and 2 each from Ethiopia, Canada, Russia, Colombia, Sweden, Greece and Peru. The rest 17 were from various countries. The articles involved six thematic areas—healthcare, education, research, industry, information technology and general concepts on CoE. The analysis documented success stories of using the brand ‘CoE’—an inﬂuential brand to stimulate best practices. We identified 12 essential foundations of CoE—specialised expertise; infrastructure; innovation; high-impact research; quality service; accreditation or standards; leadership; organisational structure; strategy; collaboration and partnership; sustainable funding or financial mechanisms; and entrepreneurship.ConclusionsCoEs have significant scientific, political, economic and social impacts. However, there are inconsistent use and self-designation of the brand without approval by an independent, external process of evaluation and with high ambiguity between ‘CoEs’ and the ordinary ‘institutions’ or ‘centres’. A comprehensive framework is needed to guide and inspire an institution as a CoE and to help government and funding institutions shape and oversee CoEs.

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Systematic and progressive implementation of the centers of excellence for rheumatoid arthritis: a methodological proposal

Cited by 7 publications

References 9 publications

<p>Clinical Outcomes of Patients with Rheumatoid Arthritis Treated in a Disease Management Program: Real-World Results</p>

<p>Clinical Outcomes of Patients with Rheumatoid Arthritis Treated in a Disease Management Program: Real-World Results</p>

Conceptualizing centers of excellence: A global evidence

Conceptualising centres of excellence: a scoping review of global evidence

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