Achalasia Quality Indicator Adherence
Background Quality indicators (QIs) are formal ways to track health care performance and outcomes, guide quality improvement, and identify gaps in care delivery. We developed twelve quality indicators for achalasia management which cover the domains of patient education, diagnosis, and treatment of...
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| Veröffentlicht in: | Digestive diseases and sciences 2023-02, Vol.68 (2), p.389-395 |
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| creator | Romanoff, Emily Zhuo, Justin Huang, Annsa C. Amador, Deron Otaki, Fouad Kamal, Afrin N. Kathpalia, Priya Leiman, David A. |
| description | Background
Quality indicators (QIs) are formal ways to track health care performance and outcomes, guide quality improvement, and identify gaps in care delivery. We developed twelve quality indicators for achalasia management which cover the domains of patient education, diagnosis, and treatment of achalasia.
Aim
To determine adherence to established quality indicators for achalasia management.
Methods
We performed a retrospective, multicenter evaluation of care patterns for adult patients greater than 18 years old with newly diagnosed achalasia from January 2018 to May 2020. A balanced random patient sample was obtained at four large academic medical centers. Independent electronic health record chart abstraction was performed using a standardized form to determine adherence to applicable QIs. Pooled and de-identified data were analyzed to identify gaps in care.
Results
A total of 120 patients were included and the overall adherence to applicable quality indicators across all centers was 86%. The median follow-up for all patients from time of diagnosis to end of study was 511 days. Clinicians adhered to all applicable quality indicators in 49 patients (39%). The quality indicator domain with the poorest adherence was patient education (67%), with 50% of patients having had a documented discussion of the risks of gastroesophageal reflux disease following surgical or endoscopic myotomy.
Conclusions
Gaps in the quality of achalasia care delivery were identified, the largest of which relates to patient education about treatment risks. These findings highlight a potential area for future quality improvement studies and form the basis for developing fully specified quality measures. |
| doi_str_mv | 10.1007/s10620-022-07658-7 |
| format | Article |
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Quality indicators (QIs) are formal ways to track health care performance and outcomes, guide quality improvement, and identify gaps in care delivery. We developed twelve quality indicators for achalasia management which cover the domains of patient education, diagnosis, and treatment of achalasia.
Aim
To determine adherence to established quality indicators for achalasia management.
Methods
We performed a retrospective, multicenter evaluation of care patterns for adult patients greater than 18 years old with newly diagnosed achalasia from January 2018 to May 2020. A balanced random patient sample was obtained at four large academic medical centers. Independent electronic health record chart abstraction was performed using a standardized form to determine adherence to applicable QIs. Pooled and de-identified data were analyzed to identify gaps in care.
Results
A total of 120 patients were included and the overall adherence to applicable quality indicators across all centers was 86%. The median follow-up for all patients from time of diagnosis to end of study was 511 days. Clinicians adhered to all applicable quality indicators in 49 patients (39%). The quality indicator domain with the poorest adherence was patient education (67%), with 50% of patients having had a documented discussion of the risks of gastroesophageal reflux disease following surgical or endoscopic myotomy.
Conclusions
Gaps in the quality of achalasia care delivery were identified, the largest of which relates to patient education about treatment risks. These findings highlight a potential area for future quality improvement studies and form the basis for developing fully specified quality measures.</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-022-07658-7</identifier><identifier>PMID: 36459295</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Achalasia ; Adolescent ; Adult ; Biochemistry ; Biopsy ; Botulinum toxin ; Care and treatment ; Classification ; Disease ; Dysphagia ; Endoscopy ; Esophageal Achalasia - diagnosis ; Esophageal Sphincter, Lower - surgery ; Esophagus ; Gastroenterology ; Gastroesophageal Reflux ; Hepatology ; Humans ; Medical care ; Medical centers ; Medical colleges ; Medical records ; Medicine ; Medicine & Public Health ; Motility ; Natural Orifice Endoscopic Surgery ; Oncology ; Original Article ; Patient education ; Quality improvement ; Quality Indicators, Health Care ; Quality management ; Retrospective Studies ; Transplant Surgery ; Treatment Outcome ; Usability</subject><ispartof>Digestive diseases and sciences, 2023-02, Vol.68 (2), p.389-395</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><rights>COPYRIGHT 2023 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-a257b1bba733cd3ab050874860e340d90909e14b950cb393a475332cd2ac415d3</citedby><cites>FETCH-LOGICAL-c442t-a257b1bba733cd3ab050874860e340d90909e14b950cb393a475332cd2ac415d3</cites><orcidid>0000-0002-2737-3291</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10620-022-07658-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10620-022-07658-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36459295$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Romanoff, Emily</creatorcontrib><creatorcontrib>Zhuo, Justin</creatorcontrib><creatorcontrib>Huang, Annsa C.</creatorcontrib><creatorcontrib>Amador, Deron</creatorcontrib><creatorcontrib>Otaki, Fouad</creatorcontrib><creatorcontrib>Kamal, Afrin N.</creatorcontrib><creatorcontrib>Kathpalia, Priya</creatorcontrib><creatorcontrib>Leiman, David A.</creatorcontrib><title>Achalasia Quality Indicator Adherence</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>Dig Dis Sci</addtitle><description>Background
Quality indicators (QIs) are formal ways to track health care performance and outcomes, guide quality improvement, and identify gaps in care delivery. We developed twelve quality indicators for achalasia management which cover the domains of patient education, diagnosis, and treatment of achalasia.
Aim
To determine adherence to established quality indicators for achalasia management.
Methods
We performed a retrospective, multicenter evaluation of care patterns for adult patients greater than 18 years old with newly diagnosed achalasia from January 2018 to May 2020. A balanced random patient sample was obtained at four large academic medical centers. Independent electronic health record chart abstraction was performed using a standardized form to determine adherence to applicable QIs. Pooled and de-identified data were analyzed to identify gaps in care.
Results
A total of 120 patients were included and the overall adherence to applicable quality indicators across all centers was 86%. The median follow-up for all patients from time of diagnosis to end of study was 511 days. Clinicians adhered to all applicable quality indicators in 49 patients (39%). The quality indicator domain with the poorest adherence was patient education (67%), with 50% of patients having had a documented discussion of the risks of gastroesophageal reflux disease following surgical or endoscopic myotomy.
Conclusions
Gaps in the quality of achalasia care delivery were identified, the largest of which relates to patient education about treatment risks. These findings highlight a potential area for future quality improvement studies and form the basis for developing fully specified quality measures.</description><subject>Achalasia</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Biochemistry</subject><subject>Biopsy</subject><subject>Botulinum toxin</subject><subject>Care and treatment</subject><subject>Classification</subject><subject>Disease</subject><subject>Dysphagia</subject><subject>Endoscopy</subject><subject>Esophageal Achalasia - diagnosis</subject><subject>Esophageal Sphincter, Lower - surgery</subject><subject>Esophagus</subject><subject>Gastroenterology</subject><subject>Gastroesophageal Reflux</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Medical care</subject><subject>Medical centers</subject><subject>Medical colleges</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Motility</subject><subject>Natural Orifice Endoscopic Surgery</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patient education</subject><subject>Quality improvement</subject><subject>Quality Indicators, Health Care</subject><subject>Quality management</subject><subject>Retrospective Studies</subject><subject>Transplant Surgery</subject><subject>Treatment Outcome</subject><subject>Usability</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU1LAzEQhoMotlb_gAcpiOBl6-S7OZbiR6Eggp5DNpttt2x3a7J76L83datFEZlDwszzvszwInSJYYQB5F3AIAgkQEgCUvBxIo9QH3NJE8LF-Bj1AYv4x1j00FkIKwBQEotT1KOCcUUU76ObiV2a0oTCDF9aUxbNdjirssKapvbDSbZ03lXWnaOT3JTBXezfAXp7uH-dPiXz58fZdDJPLGOkSQzhMsVpaiSlNqMmBQ5jycYCHGWQKYjlMEsVB5tSRQ2TnFJiM2IswzyjA3Tb-W58_d660Oh1EawrS1O5ug2aSCaoIljgiF7_Qld166u4XaQkVUpwIQ7UwpROF1VeN97YnameSCoIVwxopEZ_ULEyty5sXbm8iP0fAtIJrK9D8C7XG1-sjd9qDHqXje6y0TEb_ZmNllF0td-4Tdcu-5Z8hREB2gEhjqqF84eT_rH9AGIHlIs</recordid><startdate>20230201</startdate><enddate>20230201</enddate><creator>Romanoff, Emily</creator><creator>Zhuo, Justin</creator><creator>Huang, Annsa C.</creator><creator>Amador, Deron</creator><creator>Otaki, Fouad</creator><creator>Kamal, Afrin N.</creator><creator>Kathpalia, Priya</creator><creator>Leiman, David A.</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2737-3291</orcidid></search><sort><creationdate>20230201</creationdate><title>Achalasia Quality Indicator Adherence</title><author>Romanoff, Emily ; Zhuo, Justin ; Huang, Annsa C. ; Amador, Deron ; Otaki, Fouad ; Kamal, Afrin N. ; Kathpalia, Priya ; Leiman, David A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-a257b1bba733cd3ab050874860e340d90909e14b950cb393a475332cd2ac415d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Achalasia</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Biochemistry</topic><topic>Biopsy</topic><topic>Botulinum toxin</topic><topic>Care and treatment</topic><topic>Classification</topic><topic>Disease</topic><topic>Dysphagia</topic><topic>Endoscopy</topic><topic>Esophageal Achalasia - diagnosis</topic><topic>Esophageal Sphincter, Lower - surgery</topic><topic>Esophagus</topic><topic>Gastroenterology</topic><topic>Gastroesophageal Reflux</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Medical care</topic><topic>Medical centers</topic><topic>Medical colleges</topic><topic>Medical records</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Motility</topic><topic>Natural Orifice Endoscopic Surgery</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patient education</topic><topic>Quality improvement</topic><topic>Quality Indicators, Health Care</topic><topic>Quality management</topic><topic>Retrospective Studies</topic><topic>Transplant Surgery</topic><topic>Treatment Outcome</topic><topic>Usability</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Romanoff, Emily</creatorcontrib><creatorcontrib>Zhuo, Justin</creatorcontrib><creatorcontrib>Huang, Annsa C.</creatorcontrib><creatorcontrib>Amador, Deron</creatorcontrib><creatorcontrib>Otaki, Fouad</creatorcontrib><creatorcontrib>Kamal, Afrin N.</creatorcontrib><creatorcontrib>Kathpalia, Priya</creatorcontrib><creatorcontrib>Leiman, David A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive diseases and sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Romanoff, Emily</au><au>Zhuo, Justin</au><au>Huang, Annsa C.</au><au>Amador, Deron</au><au>Otaki, Fouad</au><au>Kamal, Afrin N.</au><au>Kathpalia, Priya</au><au>Leiman, David A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Achalasia Quality Indicator Adherence</atitle><jtitle>Digestive diseases and sciences</jtitle><stitle>Dig Dis Sci</stitle><addtitle>Dig Dis Sci</addtitle><date>2023-02-01</date><risdate>2023</risdate><volume>68</volume><issue>2</issue><spage>389</spage><epage>395</epage><pages>389-395</pages><issn>0163-2116</issn><eissn>1573-2568</eissn><abstract>Background
Quality indicators (QIs) are formal ways to track health care performance and outcomes, guide quality improvement, and identify gaps in care delivery. We developed twelve quality indicators for achalasia management which cover the domains of patient education, diagnosis, and treatment of achalasia.
Aim
To determine adherence to established quality indicators for achalasia management.
Methods
We performed a retrospective, multicenter evaluation of care patterns for adult patients greater than 18 years old with newly diagnosed achalasia from January 2018 to May 2020. A balanced random patient sample was obtained at four large academic medical centers. Independent electronic health record chart abstraction was performed using a standardized form to determine adherence to applicable QIs. Pooled and de-identified data were analyzed to identify gaps in care.
Results
A total of 120 patients were included and the overall adherence to applicable quality indicators across all centers was 86%. The median follow-up for all patients from time of diagnosis to end of study was 511 days. Clinicians adhered to all applicable quality indicators in 49 patients (39%). The quality indicator domain with the poorest adherence was patient education (67%), with 50% of patients having had a documented discussion of the risks of gastroesophageal reflux disease following surgical or endoscopic myotomy.
Conclusions
Gaps in the quality of achalasia care delivery were identified, the largest of which relates to patient education about treatment risks. These findings highlight a potential area for future quality improvement studies and form the basis for developing fully specified quality measures.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>36459295</pmid><doi>10.1007/s10620-022-07658-7</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-2737-3291</orcidid></addata></record> |
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| subjects | Achalasia Adolescent Adult Biochemistry Biopsy Botulinum toxin Care and treatment Classification Disease Dysphagia Endoscopy Esophageal Achalasia - diagnosis Esophageal Sphincter, Lower - surgery Esophagus Gastroenterology Gastroesophageal Reflux Hepatology Humans Medical care Medical centers Medical colleges Medical records Medicine Medicine & Public Health Motility Natural Orifice Endoscopic Surgery Oncology Original Article Patient education Quality improvement Quality Indicators, Health Care Quality management Retrospective Studies Transplant Surgery Treatment Outcome Usability |
| title | Achalasia Quality Indicator Adherence |
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