Skip to main content
Top
Published in: Arthritis Research & Therapy 1/2015

Open Access 01-12-2015 | Research article

Development of key performance indicators to evaluate centralized intake for patients with osteoarthritis and rheumatoid arthritis

Authors: Claire E. Barber, Jatin N. Patel, Linda Woodhouse, Christopher Smith, Stephen 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

Published in: Arthritis Research & Therapy | Issue 1/2015

Login to get access

Abstract

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.
Appendix
Available only for authorised users
Literature
2.
go back to reference Desmeules F, Dionne CE, Belzile ÉL, Bourbonnais R, Frémont P. The impacts of pre-surgery wait for total knee replacement on pain, function and health-related quality of life six months after surgery. J Eval Clin Pract. 2012;18:111–20.CrossRefPubMed Desmeules F, Dionne CE, Belzile ÉL, Bourbonnais R, Frémont P. The impacts of pre-surgery wait for total knee replacement on pain, function and health-related quality of life six months after surgery. J Eval Clin Pract. 2012;18:111–20.CrossRefPubMed
3.
go back to reference Desmeules F, Dionne CE, Belzile É, Bourbonnais R, Frémont P. The burden of wait for knee replacement surgery: effects on pain, function and health-related quality of life at the time of surgery. Rheumatology (Oxford). 2010;49:945–54.CrossRef Desmeules F, Dionne CE, Belzile É, Bourbonnais R, Frémont P. The burden of wait for knee replacement surgery: effects on pain, function and health-related quality of life at the time of surgery. Rheumatology (Oxford). 2010;49:945–54.CrossRef
4.
go back to reference Ackerman IN, Bennell KL, Osborne RH. Decline in health-related quality of life reported by more than half of those waiting for joint replacement surgery: a prospective cohort study. BMC Musculoskelet Disord. 2011;12:108.PubMedCentralCrossRefPubMed Ackerman IN, Bennell KL, Osborne RH. Decline in health-related quality of life reported by more than half of those waiting for joint replacement surgery: a prospective cohort study. BMC Musculoskelet Disord. 2011;12:108.PubMedCentralCrossRefPubMed
5.
go back to reference Lard LR, Visser H, Speyer I, Vander Horst-Bruinsma IE, Zwinderman AH, Breedveld FC, et al. Early versus delayed treatment in patients with recent-onset rheumatoid arthritis: comparison of two cohorts who received different treatment strategies. Am J Med. 2001;111:446–51.CrossRefPubMed Lard LR, Visser H, Speyer I, Vander Horst-Bruinsma IE, Zwinderman AH, Breedveld FC, et al. Early versus delayed treatment in patients with recent-onset rheumatoid arthritis: comparison of two cohorts who received different treatment strategies. Am J Med. 2001;111:446–51.CrossRefPubMed
6.
go back to reference Nell VP, Machold KP, Eberl G, Stamm TA, Uffmann M, Smolen JS. Benefit of very early referral and very early therapy with disease-modifying anti-rheumatic drugs in patients with early rheumatoid arthritis. Rheumatology (Oxford). 2004;43:906–14.CrossRef Nell VP, Machold KP, Eberl G, Stamm TA, Uffmann M, Smolen JS. Benefit of very early referral and very early therapy with disease-modifying anti-rheumatic drugs in patients with early rheumatoid arthritis. Rheumatology (Oxford). 2004;43:906–14.CrossRef
7.
go back to reference van der Linden MP, le Cessie S, Raza K, van der Woude D, Knevel R, Huizinga TW, et al. Long-term impact of delay in assessment of patients with early arthritis. Arthritis Rheum. 2010;62:3537–46.CrossRefPubMed van der Linden MP, le Cessie S, Raza K, van der Woude D, Knevel R, Huizinga TW, et al. Long-term impact of delay in assessment of patients with early arthritis. Arthritis Rheum. 2010;62:3537–46.CrossRefPubMed
8.
go back to reference Bykerk VP, Akhavan P, Hazlewood GS, Schieir O, Dooley A, Haraoui B, et al. Canadian Rheumatology Association recommendations for pharmacological management of rheumatoid arthritis with traditional and biologic disease-modifying antirheumatic drugs. J Rheumatol. 2012;39:1559–82.CrossRefPubMed Bykerk VP, Akhavan P, Hazlewood GS, Schieir O, Dooley A, Haraoui B, et al. Canadian Rheumatology Association recommendations for pharmacological management of rheumatoid arthritis with traditional and biologic disease-modifying antirheumatic drugs. J Rheumatol. 2012;39:1559–82.CrossRefPubMed
9.
go back to reference Bykerk VP, Baron M, Boire G, Haraoui B, Khrashi M, LeClercq S, et al. Canadian Consensus Statement on Early Optimal Therapy in Early Rheumatoid Arthritis. CRAJ J Can Rheumatol Assoc. 2004;14 Autumn:11–3. Bykerk VP, Baron M, Boire G, Haraoui B, Khrashi M, LeClercq S, et al. Canadian Consensus Statement on Early Optimal Therapy in Early Rheumatoid Arthritis. CRAJ J Can Rheumatol Assoc. 2004;14 Autumn:11–3.
10.
go back to reference Smolen JS, Landewé R, Breedveld FC, Buch M, Burmester G, Dougados M, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis. 2014;73:492–509.PubMedCentralCrossRefPubMed Smolen JS, Landewé R, Breedveld FC, Buch M, Burmester G, Dougados M, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis. 2014;73:492–509.PubMedCentralCrossRefPubMed
11.
go back to reference Singh JA, Furst DE, Bharat A, Curtis JR, Kavanaugh AF, Kremer JM, et al. 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2012;64:625–39.CrossRef Singh JA, Furst DE, Bharat A, Curtis JR, Kavanaugh AF, Kremer JM, et al. 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2012;64:625–39.CrossRef
14.
go back to reference Widdifield J, Paterson JM, Bernatsky S, Tu K, Thorne JC, Ahluwalia V, et al. The rising burden of rheumatoid arthritis surpasses rheumatology supply in Ontario. Can J Public Health. 2013;104:e450–5.PubMed Widdifield J, Paterson JM, Bernatsky S, Tu K, Thorne JC, Ahluwalia V, et al. The rising burden of rheumatoid arthritis surpasses rheumatology supply in Ontario. Can J Public Health. 2013;104:e450–5.PubMed
15.
go back to reference Badley EM, Canizares M, Gunz AC, Davis AM. Visits to rheumatologists for arthritis: the role of access to primary care physicians, geographic availability of rheumatologists, and socioeconomic status. Arthritis Care Res (Hoboken). 2015;67:230–9.CrossRef Badley EM, Canizares M, Gunz AC, Davis AM. Visits to rheumatologists for arthritis: the role of access to primary care physicians, geographic availability of rheumatologists, and socioeconomic status. Arthritis Care Res (Hoboken). 2015;67:230–9.CrossRef
16.
go back to reference Kur J, Koehler B. Rheumatologist demographics in British Columbia: a looming crisis. B C Med J. 2011;53:128–31. Kur J, Koehler B. Rheumatologist demographics in British Columbia: a looming crisis. B C Med J. 2011;53:128–31.
17.
go back to reference Badley EM, Canizares M, Mahomed N, Veinot P, Davis AM. Provision of orthopaedic workforce and implications for access to orthopaedic services in Ontario. J Bone Joint Surg Am. 2011;93:863–70.CrossRefPubMed Badley EM, Canizares M, Mahomed N, Veinot P, Davis AM. Provision of orthopaedic workforce and implications for access to orthopaedic services in Ontario. J Bone Joint Surg Am. 2011;93:863–70.CrossRefPubMed
18.
go back to reference Fyie K, Frank C, Noseworthy T, Christiansen T, Marshall DA. Evaluating the primary-to-specialist referral system for elective hip and knee arthroplasty. J Eval Clin Pract. 2014;20:66–73.CrossRefPubMed Fyie K, Frank C, Noseworthy T, Christiansen T, Marshall DA. Evaluating the primary-to-specialist referral system for elective hip and knee arthroplasty. J Eval Clin Pract. 2014;20:66–73.CrossRefPubMed
19.
20.
go back to reference Novak K, Veldhuyzen Van Zanten S, Pendharkar SR. Improving access in gastroenterology: the single point of entry model for referrals. Can J Gastroenterol. 2013;27:633–5.PubMedCentralPubMed Novak K, Veldhuyzen Van Zanten S, Pendharkar SR. Improving access in gastroenterology: the single point of entry model for referrals. Can J Gastroenterol. 2013;27:633–5.PubMedCentralPubMed
21.
go back to reference van den Heuvel B, Vair B, Porter G, Klassen D, Inglis K, Bonjer HJ. Patient compliance with a group model of care: the hernia clinic. Can J Surg. 2012;55:259–63.PubMedCentralCrossRefPubMed van den Heuvel B, Vair B, Porter G, Klassen D, Inglis K, Bonjer HJ. Patient compliance with a group model of care: the hernia clinic. Can J Surg. 2012;55:259–63.PubMedCentralCrossRefPubMed
22.
go back to reference Damani Z, Conner-Spady B, Noseworthy TW. Value and acceptability of single-entry models in health care [poster P4-39]. Presented at the 35th Annual Meeting of the Society for Medical Decision Making. Bench, Bedside and Beyond: Medical Decision Making and Public Policy, Baltimore, MD, USA. Damani Z, Conner-Spady B, Noseworthy TW. Value and acceptability of single-entry models in health care [poster P4-39]. Presented at the 35th Annual Meeting of the Society for Medical Decision Making. Bench, Bedside and Beyond: Medical Decision Making and Public Policy, Baltimore, MD, USA.
24.
26.
go back to reference Barber C, Marshall D, Mosher D, Akhavan P, Tucker L et al. Development of System-Level Performance Measures for Evaluation of Models of Care for Inflammatory Arthritis in Canada. J Rheumatol (In Press). Barber C, Marshall D, Mosher D, Akhavan P, Tucker L et al. Development of System-Level Performance Measures for Evaluation of Models of Care for Inflammatory Arthritis in Canada. J Rheumatol (In Press).
27.
go back to reference Frank C, Marshall D, Faris P, Smith C, Alberta Bone and Joint Health Institute. Essay for the CIHR/CMAJ award: improving access to hip and knee replacement and its quality by adopting a new model of care in Alberta. CMAJ. 2011;183:E347–50.PubMedCentralCrossRefPubMed Frank C, Marshall D, Faris P, Smith C, Alberta Bone and Joint Health Institute. Essay for the CIHR/CMAJ award: improving access to hip and knee replacement and its quality by adopting a new model of care in Alberta. CMAJ. 2011;183:E347–50.PubMedCentralCrossRefPubMed
28.
go back to reference Gooch K, Marshall DA, Faris PD, Khong H, Wasylak T, Pearce T, et al. Comparative effectiveness of alternative clinical pathways for primary hip and knee joint replacement patients: a pragmatic randomized, controlled trial. Osteoarthritis Cartilage. 2012;20:1086–94.CrossRefPubMed Gooch K, Marshall DA, Faris PD, Khong H, Wasylak T, Pearce T, et al. Comparative effectiveness of alternative clinical pathways for primary hip and knee joint replacement patients: a pragmatic randomized, controlled trial. Osteoarthritis Cartilage. 2012;20:1086–94.CrossRefPubMed
29.
go back to reference Gooch KL, Smith D, Wasylak T, Faris PD, Marshall DA, Khong H, et al. The Alberta Hip and Knee Replacement Project: a model for health technology assessment based on comparative effectiveness of clinical pathways. Int J Technol Assess Health Care. 2009;25:113–23.CrossRefPubMed Gooch KL, Smith D, Wasylak T, Faris PD, Marshall DA, Khong H, et al. The Alberta Hip and Knee Replacement Project: a model for health technology assessment based on comparative effectiveness of clinical pathways. Int J Technol Assess Health Care. 2009;25:113–23.CrossRefPubMed
30.
go back to reference Strömbeck B, Petersson IF, Vliet Vlieland TPM; EUMUSC.net WP6 group. Health care quality indicators on the management of rheumatoid arthritis and osteoarthritis: a literature review. Rheumatology (Oxford). 2013;52:382–90.CrossRef Strömbeck B, Petersson IF, Vliet Vlieland TPM; EUMUSC.net WP6 group. Health care quality indicators on the management of rheumatoid arthritis and osteoarthritis: a literature review. Rheumatology (Oxford). 2013;52:382–90.CrossRef
32.
go back to reference Dalal S, Khodyakov D, Srinivasan R, Straus S, Adams J. ExpertLens: a system for eliciting opinions from a large pool of non-collocated experts with diverse knowledge. Technol Forecast Soc Change. 2011;78:1426–44.CrossRef Dalal S, Khodyakov D, Srinivasan R, Straus S, Adams J. ExpertLens: a system for eliciting opinions from a large pool of non-collocated experts with diverse knowledge. Technol Forecast Soc Change. 2011;78:1426–44.CrossRef
33.
go back to reference Khodyakov D, Hempel S, Rubenstein L, Shekelle P, Foy R, Salem-Schatz S, et al. Conducting online expert panels: a feasibility and experimental replicability study. BMC Med Res Methodol. 2011;11:174.PubMedCentralCrossRefPubMed Khodyakov D, Hempel S, Rubenstein L, Shekelle P, Foy R, Salem-Schatz S, et al. Conducting online expert panels: a feasibility and experimental replicability study. BMC Med Res Methodol. 2011;11:174.PubMedCentralCrossRefPubMed
34.
go back to reference Basger BJ, Chen TF, Moles RJ. Validation of prescribing appropriateness criteria for older Australians using the RAND/UCLA appropriateness method. BMJ Open. 2012;2:e001431.PubMedCentralCrossRefPubMed Basger BJ, Chen TF, Moles RJ. Validation of prescribing appropriateness criteria for older Australians using the RAND/UCLA appropriateness method. BMJ Open. 2012;2:e001431.PubMedCentralCrossRefPubMed
35.
go back to reference De Coster C, McMillan S, Brant R, McGurran J, Noseworthy T, Primary Care Panel of the Western Canada Waiting List Project. The Western Canada Waiting List Project: development of a priority referral score for hip and knee arthroplasty. J Eval Clin Pract. 2007;13:192–7.CrossRefPubMed De Coster C, McMillan S, Brant R, McGurran J, Noseworthy T, Primary Care Panel of the Western Canada Waiting List Project. The Western Canada Waiting List Project: development of a priority referral score for hip and knee arthroplasty. J Eval Clin Pract. 2007;13:192–7.CrossRefPubMed
36.
go back to reference Ackerman IN, Dieppe PA, March LM, Roos EM, Nilsdotter AK, Brown GC, et al. Variation in age and physical status prior to total knee and hip replacement surgery: a comparison of centers in Australia and Europe. Arthritis Rheum. 2009;61:166–73.CrossRefPubMed Ackerman IN, Dieppe PA, March LM, Roos EM, Nilsdotter AK, Brown GC, et al. Variation in age and physical status prior to total knee and hip replacement surgery: a comparison of centers in Australia and Europe. Arthritis Rheum. 2009;61:166–73.CrossRefPubMed
37.
go back to reference Finckh A, Liang MH, van Herckenrode CM, de Pablo P. Long-term impact of early treatment on radiographic progression in rheumatoid arthritis: a meta-analysis. Arthritis Rheum. 2006;55:864–72.CrossRefPubMed Finckh A, Liang MH, van Herckenrode CM, de Pablo P. Long-term impact of early treatment on radiographic progression in rheumatoid arthritis: a meta-analysis. Arthritis Rheum. 2006;55:864–72.CrossRefPubMed
38.
go back to reference Yank G. Quality improvement in health care organizations: a general systems perspective. Behav Sci. 1995;40:85–103.CrossRefPubMed Yank G. Quality improvement in health care organizations: a general systems perspective. Behav Sci. 1995;40:85–103.CrossRefPubMed
39.
go back to reference Marshall D, Christiansen T, Smith C, Howden JS, Werle J, Fyie K, et al. Voluntary versus involuntary waiting for joint replacements: new Alberta wait times rules for hip and knee arthroplasties, with provincial consensus. Healthc Q. 2012;15:37–42.CrossRefPubMed Marshall D, Christiansen T, Smith C, Howden JS, Werle J, Fyie K, et al. Voluntary versus involuntary waiting for joint replacements: new Alberta wait times rules for hip and knee arthroplasties, with provincial consensus. Healthc Q. 2012;15:37–42.CrossRefPubMed
42.
go back to reference Canizares M, Badley E, Davis A, MacKay C, Mahomed N. Orthopaedic surgery in Ontario in the era of the Wait Time Strategy. Toronto: Arthritis Community Research & Evaluation Unit, Toronto Western Research Institute; 2007. http://www.acreu.ca/pdf/pub5/07-02.pdf. Accessed 5 Nov 2015. Canizares M, Badley E, Davis A, MacKay C, Mahomed N. Orthopaedic surgery in Ontario in the era of the Wait Time Strategy. Toronto: Arthritis Community Research & Evaluation Unit, Toronto Western Research Institute; 2007. http://​www.​acreu.​ca/​pdf/​pub5/​07-02.​pdf. Accessed 5 Nov 2015.
43.
go back to reference Noseworthy TW, McGurran JJ, Hadorn DC, Steering Committee of the Western Canada Waiting List Project. Waiting for scheduled services in Canada: development of priority-setting scoring systems. J Eval Clin Pract. 2003;9:23–31.CrossRefPubMed Noseworthy TW, McGurran JJ, Hadorn DC, Steering Committee of the Western Canada Waiting List Project. Waiting for scheduled services in Canada: development of priority-setting scoring systems. J Eval Clin Pract. 2003;9:23–31.CrossRefPubMed
44.
go back to reference Arnett G, Hadorn DC, Steering Committee of the Western Canada Waiting List Project. Developing priority criteria for hip and knee replacement: results from the Western Canada Waiting List Project. Can J Surg. 2003;46:290–6.PubMedCentralPubMed Arnett G, Hadorn DC, Steering Committee of the Western Canada Waiting List Project. Developing priority criteria for hip and knee replacement: results from the Western Canada Waiting List Project. Can J Surg. 2003;46:290–6.PubMedCentralPubMed
45.
go back to reference Camacho FT, Feldman SR, Balkrishnan R, Kong MC, Anderson RT. Validation and reliability of 2 specialty care satisfaction scales. Am J Med Qual. 2009;24:12–8.CrossRefPubMed Camacho FT, Feldman SR, Balkrishnan R, Kong MC, Anderson RT. Validation and reliability of 2 specialty care satisfaction scales. Am J Med Qual. 2009;24:12–8.CrossRefPubMed
47.
go back to reference Deloitte & Touche LLP and affiliated entities. Evaluation of central intake and assessment centres for hip and knee replacement. Ottawa, ON, Canada: Ministry of Health and Long-Term Care Ontario; 2011. Deloitte & Touche LLP and affiliated entities. Evaluation of central intake and assessment centres for hip and knee replacement. Ottawa, ON, Canada: Ministry of Health and Long-Term Care Ontario; 2011.
Metadata
Title
Development of key performance indicators to evaluate centralized intake for patients with osteoarthritis and rheumatoid arthritis
Authors
Claire E. Barber
Jatin N. Patel
Linda Woodhouse
Christopher Smith
Stephen 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
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 1/2015
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/s13075-015-0843-7

Other articles of this Issue 1/2015

Arthritis Research & Therapy 1/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.