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Instituto Nacional de Salud Pública

2019, Number 1

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salud publica mex 2019; 61 (1)

Quality care indicators for neonates with selected pathologies: pilot study

Saturno-Hernández PJ, Poblano-Verástegui O, Flores-Hernández S, Ángel-García D, O’Shea-Cuevas GJ, Villagrán-Muñoz VM, Halley-Castillo ME, Delgado-Sánchez V

Language: Spanish
References: 47
Page: 35-45
PDF size: 444.88 Kb.


ABSTRACT

Objective. Develop and pilot indicators of quality of care to neonates with relevant conditions in Mexico (prematurity, neonatal sepsis, perinatal asphyxia, and intrauterine hypoxia). Materials and methods. Own indicators were built based on key recommendations of national clinical practice guidelines and indicators found in international repositories. With previous search, selection and prioritization, the indicators were piloted within two hospitals. The feasibility of measuring, (kappa index) reliability and usefulness was analyzed to detect quality problems. Results. 23 indicators were selected and piloted, 12 are compounds, of the total, nine were feasible and reliable. The quality of the hospital‘s information was diverse and often poor, limiting both the feasibility and the reliability of the indicators. Improvement opportunities were identified thorough the compliance levels. Conclusions. A set of nine indicators valid, reliable, feasible and useful indicators is proposed in order to monitor the quality of care of pathological neonates.


REFERENCES

  1. UNICEF, WHO, World Bank U-DPD. WHO Levels and trends in child mortality report 2017 [monografía en internet] Ginebra: WHO, 2017 [citado noviembre 1, 2017]. Disponible en: http://www.who.int/maternal_ child_adolescent/documents/levels_trends_child_mortality_2017/ en/#.WfpO70TSISU

  2. The World Bank. Mortality rate, infant (per 1 000 live births) 2014 [citado noviembre 3, 2017]. Disponible en: http://data.worldbank.org/indicator/ SP.DYN.IMRT.IN

  3. Gobierno de la República. Plan Nacional de desarrollo 2013-2018: Programa Sectorial de Salud. México DF: Gobierno de la República, 2013.

  4. Muñoz-Hernández O, Chertorivski-Woldenberg S, Cortés-Gallo G, Pérez-Cuevas R. The Medical Insurance for a New Generation: A viable answer for the health needs of Mexican children. Salud Publica Mex. 2012;54(suppl.1):S3-10.

  5. Graham WJ, Varghese B. Quality, quality, quality: gaps in the continuum of care. Lancet. 2012;379(9811):e5–6. https://doi.org/10.1016/S0140- 6736(10)62267-2

  6. Scott KW, Jha AK. Putting Quality on the Global Health Agenda. N Engl J Med. 2014;371(1):3-5. https://doi.org/10.1056/NEJMp1402157

  7. Shekelle PG. Quality indicators and performance measures: methods for development need more standardization. J Clin Epidemiol. 2013;66(12):1338-9. https://doi.org/10.1016/j.jclinepi.2013.06.012

  8. World Health Organization. Consultation on Improving measurement of the quality of maternal, newborn and child care in health facilities [monografía en internet]. France: Ferney Voltaire, 2014 [citado mayo 6, 2016]. Disponible en: http://apps.who.int/iris/bitstre am/10665/128206/1/9789241507417_eng.pdf

  9. Jabbari H, Abdollahi-Sabet S, Heidarzadeh M. Hospital Care for Newborn Babies: Quality Assessment, A Systematic Review. Iran J Pediatr. 2015;25(5). https://doi.org/10.5812/ijp.3706

  10. World Health Organization. WHO mortality database [monografía en internet]. Ginebra: WHO, 2016 [citado mayo 6, 2016]. Disponible en: http://www.who.int/healthinfo/mortality_data/en/

  11. Leal YA, Álvarez-Nemegyei J, Velázquez JR, Rosado-Quiab U, Diego- Rodríguez N, Paz-Baeza E, et al. Risk factors and prognosis for neonatal sepsis in southeastern Mexico: analysis of a four-year historic cohort follow-up. BMC Pregnancy Childbirth. 2012;12:48. https://doi. org/10.1186/1471-2393-12-48

  12. Hernández B, Ortiz-Panozo E, Pérez-Cuevas R. Facility-based care for delivery and management of complications related to pregnancy and childbirth in Mexico. Salud Publica Mex. 2012;54(5):496-505.

  13. Pileggi-Castro C, Camelo Jr J, Perdoná G, Mussi-Pinhata M, Cecatti J, Mori R, et al. Development of criteria for identifying neonatal near-miss cases: analysis of two WHO multicountry cross-sectional studies. BJOG An Int J Obstet Gynaecol. 2014;121(s1):110-8. https://doi. org/10.1111/1471-0528.12637

  14. Hofer TP, Bernstein SJ, Hayward RA, DeMonner S. Validating quality indicators for hospital care. Jt Comm J Qual Improv. 1997;23(9):455-67. https://doi.org/10.1016/S1070-3241(16)30332-7

  15. Mainz J. Developing evidence-based clinical indicators: a state of the art methods primer. Int J Qual Health Care. 2003;15(Suppl 1):i5-11. https:// doi.org/10.1093/intqhc/mzg084

  16. Rubin HR, Pronovost P, Diette GB. From a process of care to a measure: the development and testing of a quality indicator. Int J Qual Health Care. 2001;13(6):489-496.

  17. Secretaría de Salud. SS-283-12. Prevención, Diagnóstico y tratamiento de sepsis y choque séptico del recién nacido en el segundo y tercer nivel de atención. Ciudad de México: Centro Nacional de Excelencia Tecnológica en Salud, 2012.

  18. Secretaría de Salud. IMSS-362-10. Manejo del Recién Nacido Prematuro Sano en la Sala de Prematuros. Ciudad de México: Instituto Méxicano del Seguro Social, Centro Nacional de Excelencia, 2010.

  19. Secretaría de Salud. IMSS-724-14. Diagnóstico y tratamiento de la apnea del prematuro. Ciudad de México: Centro Nacional de Excelencia Tecnológica en Salud, 2014.

  20. Secretaría de Salud. IMSS-632-13. Prevención, Diagnóstico y tratamiento de la asfixia neonatal. Ciudad de México: Centro Nacional de Excelencia Tecnológica en Salud, 2011.

  21. Secretaría de Salud. IMSS-540-12. Tratamiento de la Anemia del Prematuro. Ciudad de México: Centro Nacional de Excelencia Tecnológica en Salud, 2012.

  22. Saturno PJ, López-Soriano F, García DA, Martínez NI. Indicadores de buenas prácticas sobre manejo del dolor. Murcia: Universidad de Murcia, Plataforma Sin Dolor, 2013.

  23. Saturno PJ, Martínez-Nicolás I, Robles-García IS, López-Soriano F, Angel-Garcia D. Development and pilot test of a new set of good practice indicators for chronic cancer pain management. Eur J Pain. 2015;19:28-38. https://doi.org/10.1002/ejp.516

  24. Saturno P, Agüero L, Fernández M, Galván A, Poblano O, Rodriguez A, et al. Evaluación de Guías de Práctica Clínica para el primer nivel de atención. Calidad formal y apego a las Guías de Práctica Clínica sobre síndrome metabólico y salud materno-infantil. Cuernavaca, México: Instituto Nacional de Salud Pública, 2016;129.

  25. García DA, Martínez NI, Saturno-Hernández PJ, López-Soriano F. Abordaje clínico del dolor lumbar crónico: síntesis de recomendaciones basadas en la evidencia de las guías de práctica clínica existentes. An Sist Sanit Navar. 2015;38(1):117-30. https://doi.org/10.4321/S1137- 66272015000100012

  26. Agency for Healthcare Research and Quality. National Quality Measures Clearinghouse [monografía en internet]. Rockville: AHRQ, 2016 [citado agosto 18, 2016]. Disponible en: https://www.qualitymeasures.ahrq.gov/

  27. Health & Social Care Information Centre. Indicator Portal [monografía en internet]. NHS Digital. [citado marzo 13, 2017]. Disponible en: http:// content.digital.nhs.uk/indicatorportal

  28. The Joint Commission. Performance Measurement [monografía en internet]. Specifications Manual for Joint Commission National Quality Core Measures, 2016 [citado noviembre 30, 2016]. Disponible en: https:// www.jointcommission.org/performance_measurement.aspx

  29. Saturno-Hernández PJ. Formato estandarizado para el desarrollo de indicadores de calidad de la atención, 2017. https://doi.org/10.6084/ m9.figshare.5135887.v1

  30. Saturno-Hernández PJ, Martínez-Nicolás I, Poblano-Verástegui O, Vértiz-Ramírez J de J, Suárez-Ortiz C, Magaña-Izquierdo M, et al. Implementación de indicadores de calidad de la atención en hospitales de tercer nivel en México: un estudio piloto. Salud Publica Mex. 2017;59(3):1- 9. https://doi.org/10.21149/8228

  31. Soria-Aledo V, Angel-Garcia D, Martinez-Nicolas I, Rebasa Cladera P, Cabezali Sanchez R, Pereira García LF. Desarrollo y estudio piloto de un conjunto esencial de indicadores para los servicios de cirugía general. Cirugía Española. 2016;94(9):502-10. https://doi.org/10.1016/j. ciresp.2016.06.009

  32. Lemeshow S, Hosmer D, Klar J, Lwanga S. Lot quality assurance sampling. In:, eds. Adequacy of sample size in health studies. Geneva: WHO, John Wiley & Sons, 1990:24-8.

  33. Saturno-Hernández P. La distribución binomial y el muestreo para la aceptación de lotes (LQAS) como métodos de monitorización en servicios de salud. Rev Calid Asist. 2000;15(2):99-107.

  34. Peña A, Virk SS, Shewchuk RM, Allison JJ, Williams OD, Kiefe CI. Validity versus feasibility for quality of care indicators: expert panel results from the MI-Plus study. Int J Qual Health Care. 2010;22(3):201-9. https://doi. org/10.1093/intqhc/mzq018

  35. Campbell SM, Kontopantelis E, Hannon K, Burke M, Barber A, Lester HE. Framework and indicator testing protocol for developing and piloting quality indicators for the UK quality and outcomes framework. BMC Fam Pract. 2011;12:85. https://doi.org/10.1186/1471-2296-12-85

  36. Cohen J. A Coefficient of Agreement for Nominal Scales. Educ Psychol Meas. 1960;20(1):37-46. https://doi.org/10.1177/001316446002000104

  37. Byrt T, Bishop J, Carlin JB. Bias, prevalence and kappa. J Clin Epidemiol. 1993;46(5):423-9. https://doi.org/10.1177/001316446002000104

  38. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159-74. https://doi. org/10.2307/2529310

  39. Chin MH, Muramatsu N. What is the quality of quality of medical care measures? Rashomon-like relativism and real-world applications. Perspect Biol Med. 2003;46(1):5-20-23. https://doi.org/10.1353/pbm.2003.0002

  40. Mainz J. Defining and classifying clinical indicators for quality improvement. Int J Qual Heal Care. 2003;15(156):523-30. https://doi.org/10.1093/ intqhc/mzg081

  41. Saturno-Hernández PJ. Métodos y herramientas para la monitorización de la calidad en servicios de salud. Cuernavaca,México: Instituto Nacional de Salud Pública, 2015:13-31.

  42. Saturno-Hernández PJ, Ofelia Poblano-Verástegui O, Ángel García D, Flores Hernández S, O´Shea Cuevas G, Villagrán Muñoz VM, et al. Propuesta de indicadores para la evaluación de los procesos de la calidad en la atención neonatal del Sistema de Protección Social en Salud de México [Indicadores publicados en internet]. Cuernavaca, México: Figshare, 2017 [citado septiembre 6, 2017] https://doi.org/10.6084/m9.figshare.5136292

  43. Barker L, Field D. Neonatal quality measures: time to show developmental progress? Arch Dis Child Fetal Neonatal. 2014;99(6):F505-9. https://doi.org/10.1136/archdischild-2013-305623

  44. Jones P, Shepherd M, Wells S, Le Fevre J, Ameratunga S. Review article: what makes a good healthcare quality indicator? A systematic review and validation study. Emerg Med Australas. 2014;26(2):113-24. https://doi. org/10.1111/1742-6723.12195

  45. Aguilera N, Marrufo GM. Can better infrastructure and quality reduce hospital infant mortality rates in Mexico? Health Policy. 2007;80(2):239-52. https://doi.org/10.1016/j.healthpol.2006.03.003

  46. World Health Organization. Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies [monografía en internet]. Geneva: World Health Organization, 2010:97 [citado junio 20, 2017] Disponible en: http://www.who.int/healthinfo/systems/ WHO_MBHSS_2010_full_web.pdf?ua=1

  47. Shiloach M, Frencher SK, Steeger JE, Rowell KS, Bartzokis K, Tomeh MG, et al. Toward Robust Information: Data Quality and Inter-Rater Reliability in the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg. 2010;210(1):6-16. https://doi. org/10.1016/j.jamcollsurg.2009.09.031




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