Background Quality indicators are standardized, evidence-based measures of health care quality, categorised as structure (to assess the care setting), process (to assess high-quality care actions by healthcare professionals) or outcome indicators (results of actions undertaken by healthcare professionals). Several quality indicator sets have been developed to standardise, measure and optimise IBD care. Our aim was to develop and validate a set to assess IBD care in Belgium and to select a subset of indicators with room for improvement that can be used to implement and improve care in clinical practice. Methods The importance of 221 quality indicators (49 structure, 135 process and 37 outcome) identified through literature was scored on a 10-point Likert scale in a two-round modified Delphi exercise by IBD experts. In a third round, the experts indicated and ranked their top 10 indicators with most room for improvement benefitting the patient in the Belgian healthcare system to agree on an improvement subset. In parallel, patient perspectives were collected through two linguistic patient focus groups, one in Flemish (6 participants) and one in French (4 participants). A final consensus meeting was organised to discuss 1) the patient perspectives gained through the focus groups, 2) the results of two Delphi scoring rounds and 3) the results of the additional ranking round. Indicators scoring ≥7 by ≥80% of the participants during the second scoring round, or based on agreement during the consensus meeting, were included in the final set. Results Thirty-two experts (11 IBD nurses and 21 clinicians including 2 paediatricians) participated in all three voting rounds, of which 19 also participated in the consensus meeting (6 IBD nurses and 13 IBD clinicians including 2 IBD paediatricians). In total, 199 quality indicators were agreed upon to assess IBD care in Belgium (41 structure, 123 process and 35 outcome). Eighteen (3 structure, 14 process and 1 outcome; Table) were retained in the improvement subset, related to patient characteristics, endoscopy guidelines, infection prevention, steroid use, the IBD care team, services provided in the IBD clinic, the documentation of patient characteristics, the care pathway and the monitoring of disease activity. The decision to include the latter five themes was driven by the importance to patients, which was evident from the patient focus groups. Conclusion An evidence and consensus based set of quality indicators was developed and validated - including an improvement subset - allowing Belgian IBD centres to evaluate quality of provided care, set up quality improvement projects and potentially launch a benchmarking study.

中文翻译：

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P335 比利时炎症性肠病质量指标集的开发和验证

背景 质量指标是标准化的、基于证据的医疗保健质量衡量标准，分为结构（评估医疗环境）、流程（评估医疗保健专业人员的高质量医疗行动）或结果指标（医疗保健专业人员采取的行动的结果） ）。已经开发了几套质量指标来标准化、衡量和优化 IBD 护理。我们的目标是开发和验证一套评估比利时 IBD 护理的指标，并选择一个有改进空间的指标子集，可用于在临床实践中实施和改善护理。方法 IBD 专家在两轮改进的德尔菲练习中采用 10 点李克特量表对通过文献确定的 221 个质量指标（49 个结构、135 个过程和 37 个结果）的重要性进行评分。在第三轮中，专家们指出并排列了比利时医疗保健系统中最有改进空间的前 10 项指标，使患者受益，从而就改进子集达成一致。与此同时，通过两个语言患者焦点小组收集患者的观点，一个是佛兰芒语（6 名参与者），另一个是法语（4 名参与者）。组织了最终共识会议，讨论 1) 通过焦点小组获得的患者观点，2) 两轮 Delphi 评分的结果以及 3) 额外排名轮的结果。在第二轮评分中，≥80%的参与者评分≥7分的指标，或根据共识会议达成一致的指标，纳入最终集。结果 32 名专家（11 名 IBD 护士和 21 名临床医生（包括 2 名儿科医生））参加了所有三轮投票，其中 19 名专家还参加了共识会议（6 名 IBD 护士和 13 名 IBD 临床医生（包括 2 名 IBD 儿科医生）。总共商定了 199 项质量指标来评估比利时的 IBD 护理（41 项结构、123 项过程和 35 项结果）。改进子集中保留了 18 个（3 个结构、14 个过程和 1 个结果；表），与患者特征、内窥镜检查指南、感染预防、类固醇使用、IBD 护理团队、IBD 诊所提供的服务、患者记录相关特征、护理途径和疾病活动监测。纳入后五个主题的决定是出于对患者的重要性，这一点从患者焦点小组中可以明显看出。结论 开发并验证了一套基于证据和共识的质量指标（包括改进子集），使比利时 IBD 中心能够评估所提供护理的质量、建立质量改进项目并可能启动基准研究。