First proposal of quality indicators and standards and recommendations to improve the healthcare in the Spanish National Registry of Hip Fracture |
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Authors: | Patricia Ysabel Condorhuamán-Alvarado Teresa Pareja-Sierra Angélica Muñoz-Pascual Pilar Sáez-López Cristina Ojeda-Thies Teresa Alarcón-Alarcón María Concepción Cassinello-Ogea Jose Luis Pérez-Castrillón Paloma Gómez-Campelo Laura Navarro-Castellanos Ángel Otero-Puime Juan Ignacio González-Montalvo |
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Institution: | 1. Servicio de Geriatría, Hospital Universitario La Paz, Madrid, Spain;2. Servicio de Geriatría, Hospital Universitario Guadalajara, Guadalajara, Spain;3. Servicio de Geriatría, Hospital General de Segovia, Segovia, Spain;4. Unidad de Geriatría, Hospital Universitario Fundación Alcorcón, Madrid, Spain;5. Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, Spain;6. IdiPAZ Instituto de Investigación Hospital Universitario La Paz, Madrid, Spain;7. Servicio de Anestesia, Hospital Universitario Miguel Servet, Zaragoza, Spain;8. Servicio de Medicina Interna, Hospital Universitario Rio Hortega, Valladolid, Spain;9. Centro de Ciencias de la Salud San Rafael, Universidad Antonio de Nebrija, Madrid, Spain;10. Registro Nacional de Fracturas de Cadera, Madrid, Spain;11. Universidad Autónoma de Madrid, Madrid, Spain |
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Abstract: | BackgroundThe Spanish National Hip Fracture Registry (or Registro Nacional de Fractura de Cadera, RNFC) is a database of hip fracture patients admitted to Spanish hospitals. Its goals include assessment and continuous improvement of the care process.ObjectivesTo (1) establish a series of indicators, (2) evaluate their initial fulfillment, (3) propose quality standards, (4) suggest recommendations to facilitate standards compliance, and (5) monitor the indicators.MethodThe indicators fulfilled the criteria of (1) evaluating the process or outcome, (2) being clinically relevant for patients, (3) being modifiable through changes in healthcare practice, and (4) being considered important by the RNFC participants. The first quartile obtained by the group of hospitals in each of the respective variables was proposed as the standard. The Indicators Advisory Committee (IAC) elaborated a list of recommendations for each indicator, based on the available evidence.ResultsSeven indicators were chosen. These indicators (its baseline compliance vs. the standard to be reached, respectively) were: the proportion of patients receiving surgery within 48 h (44% vs. 63%), mobilized the first postoperative day (56% vs. 86%), with antiosteoporotic medication at discharge (32% vs. 61%), with calcium supplements at discharge (46% vs. 77%), with vitamin D supplements at discharge (67% vs. 92%), who developed pressure ulcers during hospitalization (7.2% vs. 2.1%) and with independent mobility at 30 days (58% vs. 70%). The IAC has established 25 recommendations for improving care.ConclusionThe indicators and standards chosen are presented, as well as the list of recommendations. This process completes the first step to improve quality of care. The results will be evaluated 6 months after implementing the recommendations. |
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Keywords: | Corresponding author Quality indicators Quality standards Hip fracture registry Indicadores de calidad Estándares de calidad Registro de fracturas de cadera |
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