Development of Key Performance Indicators to Evaluate Centralized Intake for Patients with Osteoarthritis and Rheumatoid Arthritis

Published in: Arthritis Research & Therapy, v. 17, no. 322, Nov. 2015, p. 1-12

Posted on RAND.org on November 30, 2015

by Claire E. Barber, Jatin N. Patel, Linda J. Woodhouse, Stephen M. Weiss, Joanne Homik, Sharon LeClercq, Dianne Mosher, Tanya Christiansen, Jane Squire Howden, Tracy Wasylak, James Greenwood-Lee, Andrea Emrick, Esther Suter, Barb Kathol, Dmitry Khodyakov, Sean Grant, Denise Campbell-Scherer, Leah Phillips, Jennifer Hendricks, Deborah A. Marshall

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INTRODUCTION: Centralized intake is integral to healthcare systems to support timely access to appropriate health services. The aim of this study was to develop key performance indicators (KPIs) to evaluate centralized intake systems for patients with osteoarthritis (OA) and rheumatoid arthritis (RA). METHODS: Phase 1 involved stakeholder meetings including healthcare providers, managers, researchers and patients to obtain input on candidate KPIs, aligned along six quality dimensions: appropriateness, accessibility, acceptability, efficiency, effectiveness, and safety. Phase 2 involved literature reviews to ensure KPIs were based on best practices and harmonized with existing measures. Phase 3 involved a three-round, online modified Delphi panel to finalize the KPIs. The panel consisted of two rounds of rating and a round of online and in-person discussions. KPIs rated as valid and important (≥7 on a 9-point Likert scale) were included in the final set. RESULTS: Twenty-five KPIs identified and substantiated during Phases 1 and 2 were submitted to 27 panellists including healthcare providers, managers, researchers, and patients in Phase 3. After the in-person meeting, three KPIs were removed and six were suggested. The final set includes 9 OA KPIs, 10 RA KPIs and 9 relating to centralized intake processes for both conditions. All 28 KPIs were rated as valid and important. CONCLUSIONS: Arthritis stakeholders have proposed 28 KPIs that should be used in quality improvement efforts when evaluating centralized intake for OA and RA. The KPIs measure five of the six dimensions of quality and are relevant to patients, practitioners and health systems.

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