Priorización de indicadores de calidad de la atención al paciente con ictus a partir de un método de consenso

Abstract

Objectives To define a core set of evidence-based performance indicators (PIs) for the assessment of in-hospital stroke care quality by means of consensus prioritisation by a panel of experts representing stroke care professionals in three Autonomous Communities (Catalonia, Aragon and Balearic Islands). Material and methods We used a modified Delphi method in two rounds to prioritise a set of PIs from among 70 indicators identified by a review of the literature and those already used in previous experiences. Consensus on validity was reached when ≥75% of panellists rated a PI in the top tertile, using a 1-9 Likert scale. On the basis of the percentage distribution of annual stroke admissions in each one of the 3 regions, we configured a multidisciplinary panel of 56 experts involved in the hospital care of acute stroke patients. Results Twenty-nine out of the 70 PIs initially put forward to the panel, have been prioritised after 2 rounds. The eventual core set of PIs consists of those with the highest scores and represent all areas of hospital-based stroke care. A subgroup of 5 PIs is applicable to Primary Stroke Centres only. The 3 highest rated PIs, which achieved the greatest consensus among the experts, are anticoagulants for AF, antithrombotics at discharge and continued physiotherapy planned at discharge. Conclusions Through a Delphi method, we have obtained a core set of evidence-based PIs considered of high importance and agreed by a multidisciplinary panel of stroke care experts from the participating Communities, which represent over 20% of the Spanish population.