所属 医学部 医学科（東京女子医科大学病院） 職種 講師
|表題||Development and Practical Test of Quality Indicators for Palliative Care in Patients With Chronic Heart Failure.|
|掲載誌名||正式名：Circulation journal : official journal of the Japanese Circulation Society|
略 称：Circ J
|出版社||The Japanese Circulation Society|
|著者・共著者||Hamatani Yasuhiro, Takada Yasuko, Miyamoto Yoshihiro, Kawano Yukie, Anchi Yuta, Shibata Tatsuhiro, Suzuki Atsushi, Nishikawa Mitsunori, Ito Hiroto, Kato Masashi, Shiga Tsuyoshi, Fukumoto Yoshihiro, Izumi Chisato, Yasuda Satoshi, Ogawa Hisao, Sugano Yasuo, Anzai Toshihisa|
|概要||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.