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Development and Practical Test of Quality Indicators for Palliative Care in Patients With Chronic Heart Failure

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Title: Development and Practical Test of Quality Indicators for Palliative Care in Patients With Chronic Heart Failure
Authors: Hamatani, Yasuhiro Browse this author
Takada, Yasuko Browse this author
Miyamoto, Yoshihiro Browse this author →KAKEN DB
Kawano, Yukie Browse this author
Anchi, Yuta Browse this author
Shibata, Tatsuhiro Browse this author
Suzuki, Atsushi Browse this author →KAKEN DB
Nishikawa, Mitsunori Browse this author
Ito, Hiroto Browse this author
Kato, Masashi Browse this author
Shiga, Tsuyoshi Browse this author
Fukumoto, Yoshihiro Browse this author →KAKEN DB
Izumi, Chisato Browse this author
Yasuda, Satoshi Browse this author
Ogawa, Hisao Browse this author →KAKEN DB
Sugano, Yasuo Browse this author →KAKEN DB
Anzai, Toshihisa Browse this author →KAKEN DB
Keywords: Heart failure
Palliative care
Quality indicators
Issue Date: Apr-2020
Publisher: 社団法人 日本循環器学会(The Japanese Circulation Society)JCS
Journal Title: 社団法人 日本循環器学会(The Japanese Circulation Society)JCS
Volume: 84
Issue: 4
Start Page: 584
End Page: 591
Publisher DOI: 10.1253/circj.CJ-19-0225
Abstract: Background: Palliative care is highly relevant for patients with heart failure (HF), and there is a need for quantitative information on quality of care. Accordingly, this study aimed to develop a set of quality indicators (QIs) for palliative care of HF patients, and to conduct a practical pilot measurement of the proposed QIs in clinical practice. Methods and Results: We used a modified Delphi technique, a consensus method that involves a comprehensive literature review, face-to-face multidisciplinary panel meeting, and anonymous rating in 2 rounds. A 15-member multidisciplinary expert panel individually rated each potential indicator on a scale of 1 (lowest) to 9 (highest) for appropriateness. All indicators receiving a median score >= 7 without significant disagreement were included in the final set of QIs. Through the consensus-building process, 35 QIs were proposed for palliative care in HF patients. Practical measurement in HF patients (n=131) from 3 teaching hospitals revealed that all of the proposed QIs could be obtained retrospectively from medical records, and the following QIs had low performance (<10%): "Intervention by multidisciplinary team", "Opioid therapy for patients with refractory dyspnea", and "Screening for psychological symptoms". Conclusions: The first set of QIs for palliative care of HF patients was developed and could clarify quantitative information and might improve the quality of care.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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