Developing and accessing clinical governance indicators of risk management and clinical effectiveness East Azerbaijan Cardiac Care Units

Abstract

Abstract: Background and Aim: Evaluating the performance in Clinical Governance (CG) activities requires specific and appropriate national indicators. The aim of this study was to develop and assess CG indicators of risk management and clinical effectiveness in East Azerbaijan Cardiac Care Units. Materials and Methods: The present study was conducted through a seven-step process including; a) A comprehensive literature review to identify potential indicators. b) Panel of Experts (100 Person - hours). c) Four Semi-structured interviews. d) Two-round Delphi survey (with 33 experts). e) Final expert panel (with7 experts).f) Developing CCU indicators (using comprehensive literature review, Panel of Experts, Semi-structured interviews, Two round Delphi survey).g) Assessing CCU indicators based on 2000 cardiovascular patient medical record files and 20 CCUs in 17 East Azerbaijan hospitals Results: Through the literature review, 361 indicators were identified (129 risk management indicators in 4 dimensions, and 232 clinical effectiveness indicators in 18 dimensions). After holding experts panel and interviews, the count of indicators was reduced to 168 (65 risk management indicators in 4 dimensions and 103 clinical effectiveness indicators in 12 dimensions).After running two rounds of Delphi, 4 other indicators were eliminated and after the final experts panel 113 indicators (43 risk management indicators in 4 dimensions and 70 clinical effectiveness indicators in 11 dimensions) were finalized. After determining CG indicators, 40 indicators were developed using literature review, an expert panel, two interviews and 2 rounds of Delphi survey to investigate service quality provided for cardiovascular admissions in CCUs Men comprised 57.2%of the studied patients. Myocardial Infarction (MI) was the most common cause of hospitalization. Overall, 202 )%10/1( deaths had happened. Hypertension and diabetes were the most common co-morbidities. Mean time from hospitalization to death was 1.28 days. Mean time Interval between the onsets of symptoms to hospitalization was 623minuts. Discussion: A set of indicators for risk management and clinical effectiveness dimensions of CG were developed to be used as a standard list by providers of healthcare in an effort to continuously evaluate and improve their performance. Assessing indicators of the service quality developed for CVD Patients admitted to CCUs showed that there is need to quality improvement interventions in this setting. Key words: Developing, Accessing, Clinical Governance, Indicators, Risk Management, Clinical Effectiveness, Cardiac Care Units