Empfehlungen für die interdisziplinäre Betreuung von Patienten mit Riesenzellarteriitis: «Giant Cell Arteritis Hospital Quality Standards» (GHOST)

Karger Kompass Pub Date : 2023-10-27 DOI:10.1159/000534264
Christoph Tappeiner
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Abstract

Objective: GCA is the commonest primary systemic vasculitis in adults, with significant health economic costs and societal burden. There is wide variation in access to secondary care GCA services, with 34% of hospitals in England not having any formal clinical pathway. Quality standards provide levers for change to improve services. Methods: The multidisciplinary steering committee were asked to anonymously put forward up to five aspects of service essential for best practice. Responses were qualitatively analysed to identify common themes, subsequently condensed into domain headings, and ranked in order of importance. Quality standards and metrics for each domain were drafted, requiring a minimum 75% agreement. Results: 13 themes were identified from the initial suggestions. Nine quality standards with auditable metrics were developed from the top 10 themes. Patient Access, glucocorticoid use, pathways, ultrasonography, temporal artery biopsy, PET scan access, rheumatology/ophthalmology expertise, education, multidisciplinary working have all been covered in these quality standards. Access to care is a strand that has run through each of the developed standards. An audit tool was developed as part of this exercise.
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建议的护理的患者Riesenzellarteriitis:«用力Cell Arteritis医院加强质量标准»(幽灵)
& lt; b>目的:& lt; / b>GCA是成人中最常见的原发性系统性血管炎,具有显著的健康经济成本和社会负担。在获得二级保健GCA服务方面存在很大差异,英格兰34%的医院没有任何正式的临床途径。质量标准提供了改进服务的杠杆。& lt; b>方法:& lt; / b>多学科指导委员会被要求匿名提出服务的五个方面,这些方面对于最佳实践至关重要。对回答进行定性分析,以确定共同主题,随后浓缩成领域标题,并按重要性排序。起草了每个领域的质量标准和指标,要求至少75%的同意。& lt; b>结果:& lt; / b>从最初的建议中确定了13个主题。从前10个主题中开发了9个具有可审计指标的质量标准。患者访问、糖皮质激素使用、路径、超声检查、颞动脉活检、PET扫描访问、风湿病学/眼科专业知识、教育、多学科工作都涵盖在这些质量标准中。获得医疗服务是贯穿每一项已制定标准的一个环节。作为该练习的一部分,开发了一个审计工具。
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