Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Indication”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources
PubMed2005

Development of a set of strategy-based system-level cancer care performance indicators in Ontario, Canada.

OBJECTIVES: To develop a set of scientifically sound and managerially useful system-level cancer care performance indicators for public reporting in Ontario, Canada. IMPLEMENTATION: Using a modified Delphi panel method, comprising a systematic literature review and multiple rounds of structured feedback from 34 experts, the Cancer Quality Council of Ontario developed a set of quality indicators spanning cancer prevention through to end-of-life care. To be useful to decision-makers and providers, indicator selection criteria included a clear focus on the cancer system, relevance to a diversity of cancer providers, a strong link to the mission and strategic objectives of the cancer system, clear directionality of indicator results, presence of targets and/or benchmarks, feasibility of populating the indicator, and credibility of the measure as an indicator of quality. To ensure that the selected indicators would measure progress over time against specific and widely accepted goals, we created a strategy map based on the five strategic objectives of the Ontario cancer system: (i) to improve the measurement and reporting of cancer quality, (ii) to increase the use of evidence and innovation in decision-making, (iii) to improve access to cancer services and reduce waiting times, (iv) to increase efficiency across the system, (v) to reduce the burden of cancer. An analysis of the mean indicator ratings by experts, and the strategy mapping exercise resulted in the identification of 36 indicators deemed suitable for routine performance measurement of the Ontario cancer system. LESSONS LEARNED: The resulting instrument incorporates a credible evidence basis for performance measurement aligned to the five strategic goals for the Ontario cancer system. It represents the integrating of a management culture, focused on the implementation of a new strategic direction for the cancer system, with the underlying evidence-based culture of clinicians.

Benchmarking↗
PubMed2006

OECD Health Care Quality Indicator Project. The expert panel on primary care prevention and health promotion.

PURPOSE: This article describes a project undertaken as part of the Organization for Economic Co-operation and Development (OECD)'s Healthcare Quality Indicator (HCQI) Project, which aimed to develop a set of quality indicators representing the domains of primary care, prevention and health promotion, and which could be used to assess the performance of primary care systems. METHODS: Existing quality indicators from around the world were mapped to an organizing framework which related primary care, prevention, and health promotion. The indicators were judged against the US Institute of Medicine's assessment criteria of importance and scientific soundness, and only those which met these criteria and were likely to be feasible were included. An initial large set of indicators was reduced by the primary care expert panel using a modified Delphi process. RESULTS: A set of 27 indicators was produced. Six of them were related to health promotion, covering health-related behaviours that are typically targeted by health education and outreach campaigns, 13 to preventive care with a focus on prenatal care and immunizations and eight to primary clinical care mainly addressing activities related to risk reduction. The indicators selected placed a strong emphasis on the public health aspects of primary care. CONCLUSIONS: This project represents an important but preliminary step towards a set of measures to evaluate and compare primary care quality. Further work is required to assess the operational feasibility of the indicators and the validity of any benchmarking data drawn from international comparisons. A conceptual framework needs to be developed that comprehensively captures the complex construct of primary care as a basis for the selection of additional indicators.

Benchmarking↗
PubMed2006

Selecting indicators for the quality of cardiac care at the health system level in Organization for Economic Co-operation and Development countries.

BACKGROUND: Cardiovascular (CV) diseases are major causes of morbidity and death in adults in the world. Major differences have been reported in the management strategies and the outcome of CV diseases within and between countries. To better understand and address these differences, there is a need for quantitative information on patient management, outcome, and prognosis. OBJECTIVE: This article describes the development of a set of quality indicators for cardiac care and summarizes work undertaken by the Cardiac Care Panel of the OECD Health Care Quality Indicators Project. METHODS: A list of 61 potential indicators was identified through a literature search, review of national measurement systems, and nomination from countries participating in the project. The Cardiac Care Panel then used a modified Delphi process developed originally by RAND to select indicators. Panel members individually rated each indicator on a scale of 1-9 for scientific soundness and importance. All indicators receiving scores of 7 or more for both importance and soundness were included in the final set. RESULTS: Seventeen cardiac indicators were selected for the final set of indicators from the following areas: acute coronary syndromes, cardiac interventions, secondary prevention, and congestive heart failure. CONCLUSIONS: The final set of 17 indicators selected by the Cardiac Care Panel constitutes a comprehensive set of measures for the most relevant domains of CV care. Nevertheless, gaps remain in the area of primary prevention and in particular in areas with rapidly changing technology and improving treatment options.

Benchmarking↗
PubMed2006

Development of quality indicators for patients undergoing colorectal cancer surgery.

BACKGROUND: Colorectal cancer is the second most common cancer type among new cancer diagnoses in the United States. Attention to the quality of surgical care for colorectal cancer is of particular importance given the increasing numbers of colorectal cancer resections performed in the aging population. A National Cancer Institute-sponsored consensus panel produced guidelines for colorectal cancer surgery in 2000. We have updated and extended that work by using a formal process to identify and rate quality indicators as valid for care during the preoperative, intraoperative, and postoperative periods. METHODS: Using a modification of the RAND/UCLA Appropriateness Methodology, we carried out structured interviews with leaders in the field of colorectal cancer surgery and systematic reviews of the literature to identify candidate quality indicators addressing perioperative care for patients undergoing surgery for colorectal cancer. A panel of 14 colorectal surgeons, general surgeons, and surgical oncologists then evaluated and formally rated the indicators using the modified Delphi method to identify valid indicators. RESULTS: A total of 142 candidate indicators were identified in six broad domains: privileging (which addresses surgical credentials), preoperative evaluation, patient-provider discussions, medication use, intraoperative care, and postoperative management. The expert panel rated 92 indicators as valid. These indicators address all domains of perioperative care for patients undergoing surgery for colorectal cancer. CONCLUSIONS: The RAND/UCLA Appropriateness Methodology can be used to identify and rate indicators of high-quality perioperative care for patients undergoing surgery for colorectal cancer. The indicators can be used as quality performance measures and for quality-improvement programs.

Colectomy↗
PubMed2005

Quality of working life indicators in Canadian health care organizations: a tool for healthy, health care workplaces?

BACKGROUND: Quality-of-work-life (QWL) includes broad aspects of the work environment that affect employee learning and health. Canadian health care organizations (HCOs) are being encouraged to monitor QWL, expanding existing occupational health surveillance capacities. AIM: To investigate the understanding, collection, diffusion and use of QWL indicators in Canadian HCOs. METHODS: We obtained cooperation from six diverse public HCOs managing 41 sites. We reviewed documentation relevant to QWL and conducted 58 focus groups/team interviews with strategic, support and programme teams. Group interviews were taped, reviewed and analysed for themes using qualitative data techniques. Indicators were classified by purpose and HCO level. RESULTS: QWL indicators, as such, were relatively new to most HCOs yet the data managed by human resource and occupational health and safety support teams were highly relevant to monitoring of employee well-being (119 of 209 mentioned indicators), e.g. sickness absence. Monitoring of working conditions (62/209) was also important, e.g. indicators of employee workload. Uncommon were indicators of biomechanical and psychosocial hazards at work, despite their being important causes of morbidity among HCO employees. Although imprecision in the definition of QWL indicators, limited links with other HCO performance measures and inadequate HCO resources for implementation were common, most HCOs cited ways in which QWL indicators had influenced planning and evaluation of prevention efforts. CONCLUSIONS: Increase in targeted HCO resources, inclusion of other QWL indicators and greater integration with HCO management systems could all improve HCO decision-makers' access to information relevant to employee health.

Canada↗
PubMed1975

Effects of pH indicators on various activities of chromatophroes of Rhodospirillum rubrum.

1. The effects of pH indicators on activities for ATP hydrolysis in the dark and ATP-Pi exchange in the dark were examined with chromatophores from Rhodospirillum rubrum. Of thirty-one pH indicators tested, eleven (metanil yellow, 2, 4-dinitrophenol, ethyl orange, bromocresol green, resazurin, neutral red, bromthymol blue, alpha-naphtholphthalein, o-cresolphthalein, phenolphthalein, and alizarin yellow G) almost completely inhibited the activities for ATP formation and ATP-Pi exchange at concentrations of 1 mM, and were studied in detail. 2. Of the eleven pH indicators, those other than alpha-naptholphthalein, o-cresolphthalein and phenolphthalein, when assayed at appropriate concentrations, inhibited ATP-Pi exchange, but not ATP hydrolysis. In ATP-Pi exchange, these eight pH indicators at the concentrations described above were competitive against Pi, and non-competitive against ATP. The remaining three kinds of pH indicators were non-competitive against either Pi or ATP, when assayed at concentrations of the dyes that inhibited both activities. 3. The amounts of pH indicators bound with chromatophores were measured. No correlation was found between the amounts of the bound dyes and the extents of their inhibition of either ATP formation or ATP-Pi exchange. 4. Ethyl orange (pKa=4.1) and 2, 4-dinitrophenol (pKa=3.9) stimulated ATP hydrolysis to the greatest extent. The latter dye was hardly bound with chromatophores. 5. The stimulatory effects of pH indicators on ATP hydrolysis were hardly affected by extraction of quinones from chromatophores. 6. Most of the pH indicators stimulated both succinate-cytochrome c2 and NADH-cytochrome c2 reductions in the dark. 7. The mechanism of uncoupling of the electron transfer system and the phosphorylation system by pH indicators and the mechanism of the coupling are discussed.

Adenosine Triphosphate↗
PubMed2002

The clinical leadership role of the CNS in the identification of nursing-sensitive and multidisciplinary quality indicator sets.

Within a team-oriented approach to healthcare, the demonstration of quality is challenging. Multidisciplinary quality indicators ideally represent all pertinent stakeholders and are preferred when evaluating the quality of care for specific patient populations. Recently, however, nursing-sensitive indicators have been developed that reflect the unique contribution of nursing to patient outcomes. Because nursing-sensitive quality indicators reflect nursings' accountability for patient care, they must also be considered when identifying indicators sets. Controversy exists concerning the appropriate definition, number, and approach to indicator identification. Many organizations are attempting to measure everything to ensure that all appropriate indicators are represented. To incorporate both nursing-sensitive and multidisciplinary quality indicators, a phased organization-wide approach is advocated. Through clinical leadership skills combined with the advanced practice roles of consultant, educator, and researcher, the clinical nurse specialist can facilitate the inclusion of relevant indicators, preserve both multidisciplinary and nursing-sensitive approaches, and maintain efficiency during the process. The clinical nurse specialist, with clinical expertise and advanced education has a unique leadership role in the identification of the resultant critical indicator matrix.

Humans↗
PubMed1993

Indicator amount, temperature, and intrinsic cardiac output affect thermodilution cardiac output accuracy and reproducibility.

OBJECTIVE: To determine the accuracy and reproducibility of four thermodilution indicators (5-mL room temperature, 10-mL room temperature, 5-mL iced, and 10-mL iced injectates) at clinically relevant flow rates. DESIGN: Quasi-experimental study. SETTING: Animal research laboratory of a health sciences university. SUBJECTS: Six virgin western-breed ewes. INTERVENTIONS: Data were collected from six ewes that had ascending aorta electromagnetic flow probes and inferior vena cava occluders. Cardiac output was manipulated by inferior vena cava occlusion and isoproterenol infusion. Four thermodilution indicators were tested at high and low levels of cardiac output and compared with the electromagnetic flowmeter measurements of cardiac output. MEASUREMENTS AND MAIN RESULTS: The indicator amounts were determined from both injectate volume and temperature difference between the injectate and blood. Using 5-mL room temperature injectate as a reference, 10-mL room contained 2 x, 5-mL iced 2.1 x, and 10-mL iced 4.1 x the indicator amount of 5-mL room temperature injectate. Approximately 210 simultaneous thermodilution and electromagnetic flow measurements were made for each injectate over a flow range of 1.5 to 15.7 L/min. For the entire cardiac output range, systematic error was not present. However, the r2 value (.92) for the 10-mL iced injectate group was greater (p < .05) than that value (.79) for the 5-mL iced injectate group, while r2 values were .79 for the 10-mL room temperature group and .49 for the 5-mL room temperature group. At flow rates of < 4.7 L/min, r2 was not different among injectates, but reduced indicator amounts progressively overestimated output (p < .05), reaching 21% for the 5-mL room temperature group. At flow rates of > 7.7 L/min, the r2 value (.81) for the 10-mL iced group was greater (p < .05) than that value (.45) for the 5-mL iced group, while r2 values were .24 for the 10-mL room temperature group and .08 for the 5-mL room temperature group. Systematic error was not present. CONCLUSIONS: At low cardiac output levels, reduced indicator impairs accuracy but not reproducibility, a phenomenon that is perhaps related to indicator loss. At high cardiac output rates, reduced indicator impairs reproducibility. This phenomenon is probably related to low signal-to-noise ratio. Thermodilution indicator amounts should be tailored to the output range.

Animals↗
PubMed2005

Validation of performance indicators for rehabilitation of workers with mental health problems.

OBJECTIVE: The objective of this study was to evaluate content validity and predictive validity of 11 performance indicators for the rehabilitation of workers with mental health problems. RESEARCH DESIGN AND SUBJECTS: Content validity was assessed by experts who evaluated the validity of the performance indicators in 2 Delphi rounds. Predictive validity was evaluated by relating the performance indicators and their sum score to the outcome of a cohort of 191 employees absent from work as a result of mental health problems. Scores for the performance indicators were obtained by processing registration forms of consultations filled out by occupational physicians. MAIN OUTCOME MEASURES: Three outcome measures were used: time to return to work, change in level of fatigue, and patient satisfaction. RESULTS: Ten of the 11 performance indicators showed adequate content validity according to the expert panel. The evaluation of predictive validity yielded mixed results. One performance indicator did not show sufficient variability and was excluded from further analysis. The sum score of 9 performance indicators and performance on the evaluation of work disabilities were significantly related to a shorter time to return to work (hazard ratio [HR], respectively, 0.7; confidence interval [CI], 0.7-0.9 and 0.5; CI, 0.2-0.9). Adequate care regarding interventions aimed at providers of care in the curative sector was related to a longer time to return to work (HR, 1.8; CI, 1.1-3.0). The linear regression revealed that the sum score was not significantly related to a change in level of fatigue. However, lower quality of overall care was significantly related to moderately higher patient satisfaction (beta=0.18; P<0.05). CONCLUSIONS: The evaluated performance indicators showed sufficient content validity and overall predictive validity, but no clear relation could be established between individual performance indicators and outcome.

Adult↗
PubMed1979

Biological indicators for the control of ethylene oxide sterilization.

A new biological indicator has been developed for the control of ethylene oxide sterilization, particularly for large scale sterilization of disposable medical equipment. The aim has been to provide the new indicator with the same resistance to the combined effect of ethylene oxide and water vapour as the biological indicator referred to by the health authorities in Scandinavia. The reference indicator contains spores of a Danish test strain, Bacillus subtilis, in sand. The new one contains spores of a test strain used extensively for biological indicators, viz. B. subtilis var. niger (B. globigii). The spores in the new preparation are dried in pieces of cotton yarn. The two indicators were exposed to ethylene oxide and water vapour in five different series of experiments and almost the same resistance was found. In simulated routine sterilization procedures, the new indicator was placed at locations not easily accessible for the gas and water vapour, and the results reflected the blockage of diffusion. The experiments included samples of household dust. The resistance of the microorganisms in the dust was compared with that of the biological indicators. Based on these comparisons, it is concluded that the resistance of the two biological indicators to ethylene oxide is in accordance with the official Scandinavian standard for sterilized medical equipment when used in the control of sterilization of products with low microbial contamination.

Bacillus subtilis↗
PubMed2000

Reactions to the use of evidence-based performance indicators in primary care: a qualitative study.

OBJECTIVES: To investigate reactions to the use of evidence-based cardiovascular and stroke performance indicators within one primary care group. DESIGN: Qualitative analysis of semi-structured interviews. SETTING: Fifteen practices from a primary care group in southern England. PARTICIPANTS: Fifty two primary health care professionals including 29 general practitioners, 11 practice managers, and 12 practice nurses. MAIN OUTCOME MEASURES: Participants' perceptions towards and actions made in response to these indicators. The barriers and facilitators in using these indicators to change practice. RESULTS: Barriers to the use of the indicators were their data quality and their technical specifications, including definitions of diseases such as heart failure and the threshold for interventions such as blood pressure control. Nevertheless, the indicators were sufficiently credible to prompt most of those in primary care teams to reflect on some aspect of their performance. The most common response was to improve data quality through increased or improved accuracy of recording. There was a lack of a coordinated team approach to decision making. Primary care teams placed little importance on the potential for performance indicators to identify and address inequalities in services between practices. The most common barrier to change was a lack of time and resources to act upon indicators. CONCLUSION: For the effective implementation of national performance indicators there are many barriers to overcome at individual, practice, and primary care group levels. Additional training and resources are required for improvements in data quality and collection, further education of all members of primary care teams, and measures to foster organisational development within practices. Unless these barriers are addressed, performance indicators could initially increase apparent variation between practices.

Adult↗
PubMed2006

[Proposed UNGASS indicators and the monitoring of the AIDS epidemic in Brazil].

The objective of this study was to analyze, on the national level, the process of monitoring the proposed UNGASS indicators through the use of the Brazilian National Program for STD/AIDS indicators. Two groups of proposed indicators were analyzed in 2002 and 2005 respectively, as part of the monitoring of the progress of the UNGASS Declaration of Commitment. The availability of information and limitations in calculating the proposed indicators in Brazil were analyzed and the appropriateness of the indicators for monitoring the epidemic in Brazil was discussed. Of the 13 quantitative indicators originally proposed by UNGASS, five were not included in the National Program. One was not included due to its qualitative nature. Two of the indicators were considered to be of little use and two were not included due to the lack of available data needed for their calculation. As the epidemic in Brazil is characterized as being concentrated, within the second group of proposed UNGASS indicators those that refer to the accompaniment of epidemic among high-risk population groups were prioritized. The study highlights that the National Program concentrates its efforts in the development, adaptation, and sharing of sampling methodologies for hard to reach populations. Such activities are geared towards estimating the size of vulnerable population groups, as well as obtaining more information regarding their knowledge, attitudes, and practices. The study concludes that by creating the possibility of international comparisons between advances achieved, the proposal of supranational indicators stimulates countries to discuss and make their construction viable. In a complementary way, the national monitoring systems should focus on program improvement by covering areas that permit the evaluation of specific control and intervention actions.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Algorithms for resource allocation of substance abuse prevention funds based on social indicators: a case study on state of Florida--Part 3.

The purpose of Part 3 is to develop an algorithm for an equitable distribution of state prevention funds to its substate jurisdictions based on the need for prevention services. In this series, the need for prevention services is measured in terms of the existing social indicators observed at the county level. In order to establish a conceptual link as well as the empirical relevance of the selected social indicators as proxy measurements of the estimated need for prevention at the county level, we have employed both concurrent and construct validity tests using the following three constructs as the criterion variables in a multiple regressing setting: 1) county-based composite drug use index score (COMDRUG) measured via the statewide drug survey; 2) county-based proportions of prevention target populations using the conceptual definition advanced by the Institute of Medicine (IOM); and 3) the composite risk factor score (COMRISK) assembled from a list of twenty-two risk and protective factors observed for each county. These constructs were identified previously in Parts 1 and 2. While employing eight social indicators to estimate the overall prevention needs observed at the county level, the social indicators thus selected were able to explain 69 percent of the variations in COMDRUG, 68 percent of the variation in the proportions of students in need of prevention services using IOM definition, and 60 percent of the variation in COMRISK. Following successful validations of the social indicators as viable media with which to estimate county-based prevention needs, the ensuing multiple regression equation is, then, used to build a resource allocation model by determining the proportion of each county's share of the total statewide COMDRUG-predicted from the social indicators and, then, by weighting the latter proportion by the population size of each county under age eighteen. In this way, we have devised county-based Prevention Needs Index (PNI) scores based solely on social indicators. Finally, the county's share of PNI score is computed as a proportion of to the total statewide PNI score. Following this line of algorithm for resource allocation, we were able to develop yet another resource allocation model solely based on social indicators without the benefits of survey data. Comparing the funding results originating from four resource allocation models (i.e., COMDRUG, IOM Definition, COMRISK, and Social Indicators), it has been learned that there is a remarkable similarity from one funding level to another. Since all four schedules of county-based prevention funding levels have shown very high intercorrelations with a range from .9862 to .9993, it has been determined that these schedules are measuring essentially either the same domain or latent domains that are functionally equivalent to one another. Accordingly, no preference is made among the resource allocation models suggested, although it is suggested that the final decision on the level of funding must be based on the selection of the schedule for resource allocation rather than the suggested amount or level of funding computed for each county.

Algorithms↗
PubMed2006

Survey of the use of quality indicators in academic radiology departments.

OBJECTIVE: Our purpose was to determine whether quality in academic radiology departments in the United States is systematically measured through indicators and evaluated by preset standards. MATERIALS AND METHODS: We performed a cross-sectional study using a validated survey sent to Society of Chairmen of Academic Radiology Departments (SCARD) members and studied type, frequency of monitoring, and use of preset standards for evaluation of quality indicators. Statistical methods were descriptive summary statistics, chi-square test, analysis of variance, and Spearman's rank correlation test. RESULTS: The response rate was 42% (55/132). Most responding hospitals were from the Northeast (20/55, 36.4%) and Midwest (18/55, 32.7%). About 58% (32/55) of the responding hospitals had more than 500 beds in operation; 50.9% (28/55) of the radiology departments performed 200,000-400,000 examinations per year. Among the 80% of departments (44/55) that monitored patient satisfaction, only 49.1% and 45.5% assessed referring physician and employee satisfaction, respectively. The most frequently monitored customer satisfaction indicator, patient satisfaction, was monitored quarterly or less frequently by 70.5% (31/44) of departments; about 45.5% (20/44) had preset standards for this indicator. MRI and CT were monitored for patient appointment access by 80% (44/55) and 72.7% (40/55) of departments, respectively; 59.1% (26/44) and 62.5% (25/40) of departments applied preset standards to these indicators, respectively. The reporting-time indicator monitored most frequently was report turnaround time (45/55, 81.8%). None of the differences in mean numbers and monitoring frequencies of the indicators and the use of preset standards to evaluate them by region and size of departments were significant (p >0.05). CONCLUSION: Use of quality management indicators, particularly customer satisfaction indicators, is not a fully standardized and established process for academic radiology departments in the United States.

Academic Medical Centers↗
PubMed1999

The extraction of quality-of-care clinical indicators from State health department administrative databases.

OBJECTIVE: To assess whether three proposed quality-of-care indicators (unplanned readmissions, hospital-acquired bacteraemia, and postoperative wound infection) can be accurately identified from State health department databases. DESIGN: Algorithms were applied to State health department databases to maximise the identification of individuals potentially positive for each indicator. Records of these patients were then examined to determine the percentage of cases that met the precise indicator definitions. SETTING: 10 public, acute-care hospitals from Victoria, South Australia and New South Wales. Data from the 1994-95 and 1995-96 financial years were collected. PARTICIPANTS: Individuals 18 years of age or older who were identified from State health department administrative databases as potentially meeting the indicator criteria. MAIN OUTCOME MEASURES: The proportion of screened cases that met the precise indicator definitions, and the elements of the indicator definitions which could not be extracted from the administrative databases. RESULTS: The proportions of cases confirmed by medical record review to be positive for the indicator events were 76.3% for unplanned readmissions within 28 days, 20% for hospital-acquired bacteraemia, 43.5% for wound infections after clean surgery, and 34.8% for wound infections after contaminated surgery. The clinical elements of each indicator definition were not easily extracted from the administrative databases. CONCLUSIONS: The three proposed clinical indicators could not be extracted from current State health department databases without an extensive process of secondary medical record review. If administrative databases are to be used for assessing quality of care, more systematic recording of data is needed.

Algorithms↗
PubMed2005

Development of prostate cancer quality indicators: a modified Delphi approach.

OBJECTIVES: There is evidence of variation in both the processes and outcomes of prostate cancer care, resulting in possible harm to patients and increased costs to the health system. Care could be improved by first identifying critical, measurable indicators that correlate with quality of care. This work was conducted to develop indicators of prostate cancer care using a modified three-step Delphi approach. METHODS: A 17-member multidisciplinary panel reviewed potential indicators extracted from the medical literature through two consecutive rounds of rating followed by consensus discussion. The panel then prioritized the indicators selected in the previous two rounds. RESULTS: Of 31 possible indicators that emerged from 49 reviewed articles, 11 were prioritized by the panel as benchmarks for assessing the quality of surgical care for prostate cancer. The 11 indicators represent three levels of measurement (regional, hospital, individual provider) across several phases of care (diagnosis, surgery, pathology, and follow-up), as well as broad measures of outcomes. CONCLUSION: A systematic evidence- and consensus-based approach was used to develop quality indicators of prostate cancer care, with a focus on pre-, peri- and post-operative care as well as outcomes. Some of the indicators selected by the panel were also recommended by a similarly structured panel process. These indicators can be used by individual providers and organizations to monitor the quality of their services, and develop interventions to address any variations.

Delphi Technique↗
PubMed2005

Development of quality indicators for sterilization practices of the central sterile supply department.

OBJECTIVE: To develop quality indicators for assessing the performance of central sterile supply department. (CSSD). MATERIAL AND METHOD: Quality indicators for sterilization in CSSD were searched by literature review and by current situation analysis by 79 infection control nurses (ICNs) and 83 heads of CSSD. Quality indicators were drafted and subsequently validated by 5 experts. The feasibility and applicability of the quality indicators were tested in 37 ICNs and 34 heads of CSSD. The quality indicators were finally refined by a forum of 5 experts and 5 representatives from CSSD. RESULTS: A total of 30 quality indicators were developed. These include 9 indicators for structure, 12 for process and 9 for output of CSSD. The quality indicators were deemed appropriate for the assessment of the quality of CSSD in Thailand. CONCLUSION: Thirty indicators were developed for assessing the quality of CSSD.

Central Supply, Hospital↗
PubMed1995

Framework for the development of environmental health indicators.

Environmental health indicators provide information about scientifically-based linkages between environment and health. This information can be used for environmental health management and decision-making. Environmental health indicators are rendered more complex than either environmental indicators or health indicators because they must take account of factors such as the variability in susceptibility in individuals and variability in co-exposures. Such variability implies that any links that are defined may not apply to all individuals or groups at all times. Individual-level epidemiological studies can contribute to establishing environmental health relationships for particular places and time periods. However, cost-efficiency demands that aggregated data and known environment and health relationships be used to derive these indicators. Environmental health indicators can therefore be constructed by linking aggregated data, or by identifying environmental indicators with a health linkage, or health indicators with an environmental linkage. The framework for environmental health indicators proposed here is an adaptation of the Pressure-State-Response framework. Its first level consists of driving forces, which create pressures on the environment. These in turn alter the state of the environment by increasing existing exposures or introducing new ones, which produces a measurable health effect. In order to rectify the problem, actions (i.e., environmental health management) must be undertaken at each level. Thus the framework becomes the Driving-force--Pressure--State--Effects--Action (DPSEA).

Causality↗