Quality indicators

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Medical institutions use quality metrics to track complications seen in hospital admissions. Similarly, morbidity and mortality conferences are held to peer review.

Quality indicators are measurable criteria or standards used to assess the quality of a product, service, process, or outcome. They are often used in various fields, including healthcare, manufacturing, software development, education, and customer service, to monitor and improve performance. Quality indicators help organizations evaluate their performance, identify areas for improvement, and track progress towards desired goals.

Here are some examples of quality indicators in different domains:

Healthcare:

Patient satisfaction rates

Hospital readmission rates

Infection rates

Medication error rates

Mortality rates

Length of hospital stay

Education:

Graduation rates Standardized test scores Student attendance rates Dropout rates Teacher-student ratio Student engagement levels Customer Service:

Average response time to customer inquiries Customer satisfaction scores First-call resolution rates Net Promoter Score (NPS) Customer retention rates

Quality indicators (QIs) are an accepted tool for measuring a hospital's performance in routine care.

Quality metrics are a key component of an effective quality management plan and are the measurements used in ensuring customers receive acceptable products or deliverables. Quality metrics are used to directly translate customer needs into acceptable performance measures in both products and processes.

Medical institutions use quality metrics to track complications seen in hospital admissions. Similarly, morbidity and mortality conferences are held to peer review complications.

The National Quality Indicators are generally divided into three main types of quality measures: Structure indicators (frameworks and resources, competence, available equipment, registers, etc.) Process indicators (activities in the patient process, e.g., diagnostics, treatment)

In neurosurgery, several quality indicators have been discussed in the past, i.e., readmission and reoperation rates, rates of nosocomial and surgical site infections, and overall length of stay, among others ^{1) 2) 3) 4)}. ^{5) 6) 7) 8)}.

While these indicators are easy to register, their clinical value remains questionable

Ren et al. examined national trends in adherence to the QIs developed by the Close The Gap-Stroke program by combining data from the health insurance claims database and electronic medical records, and the association between adherence to these QIs and early acute ischemic stroke outcome in Japan patients

In a study, patients with acute ischemic stroke who received acute reperfusion therapy in 351 Close The Gap-Stroke-participating hospitals were analyzed retrospectively. The primary outcomes were changes in trends for adherence to the defined QIs by difference-in-difference analysis and the effects of adherence to distinct QIs on in-hospital outcomes at the individual level. A mixed logistic regression model was adjusted for patient and hospital characteristics (eg, age, sex, number of beds) and hospital units as random effects.

Between 2013 and 2017, 21 651 patients (median age, 77 years; 43.0% female) were assessed. Of the 25 defined measures, marked and sustainable improvement in the adherence rates were observed for a door-to-needle time, door-to-puncture time, proper use of endovascular thrombectomy, and successful revascularization. The in-Hospital mortality rate was 11.6%. Adherence to 14 QIs lowered the odds of in-Hospital mortality (odds ratio [95% CI], door-to-needle <60 min, 0.80 [0.69-0.93], door-to-puncture <90 min, 0.80 [0.67-0.96], successful revascularization, 0.40 [0.34-0.48]), and adherence to 11 QIs increased the odds of functional independence (modified Rankin Scale score 0-2) at discharge.

They demonstrated national marked and sustainable improvement in adherence to door-to-needle time, door-to-puncture time, and successful reperfusion from 2013 to 2017 in Japan in patients with acute ischemic stroke. Adhering to the key QIs substantially affected in-hospital outcomes, underlining the importance of monitoring the quality of care using evidence-based QIs and the nationwide Close The Gap-Stroke program ⁹⁾.