Table : Categorisation of the prioritisation criteria Criteria Type Assessment of the criteria 1.1 There are serious Prioritisation Areas of medicine where there are serious consequences for the consequences for the patient if poor quality patient associated with poor care is delivered should be prioritised for quality care for the clinical registry development as these have the condition or with poor quality greatest impacts on patient morbidity, of the device or procedure. mortality and quality of life. Sub-optimal outcomes may also result in repeat hospitalisations and increased use of healthcare resources. This criterion was used to rank domains in terms of priority. 1.2 An evidence-based, well Threshold The core purpose of clinical quality registries executed sequence of care is to identify and address unwarranted improves patient outcomes variation from defined sequences of care. for the clinical condition. Where no evidence-based sequence of care has been defined, registries will be unable to collect longitudinal health outcome data for the eligible patient population and generate risk-adjusted reports on the appropriateness and effectiveness of health care. In some cases, the sequence of care for a clinical condition is articulated in clinical practice guidelines. Other clinical conditions may not have clinical practice guidelines that describe the appropriate sequence of care; however a well-executed sequence of care has been shown to influence patient outcomes. The importance of this criterion to the utility of a clinical quality registry was confirmed by a number of workshop participants. Where no evidence of a well-executed sequence of care was found in the literature or the existence of a functional clinical quality registry (national or international) shortlisted domains were excluded from further prioritisation. Domains that do not meet this criterion may benefit from research, epidemiological or other types of registries to improve understanding of the incidence and illness trajectory of clinical conditions and develop an evidence-based sequence of care. 1.3 Unwarranted variation Threshold Some clinical conditions may have a from this sequence of care sequence of care, but unwanted can be identified and variation from this sequence of care can be addressed. difficult to identify and/or address. This can occur where a condition has a long illness
Table : Categorisation of the prioritisation criteria Criteria Type Assessment of the criteria 1.1 There are serious consequences for the patient associated with poor quality care for the clinical condition or with poor quality of the device or procedure. Prioritisation Areas of medicine where there are serious consequences for the patient if poor quality care is delivered should be prioritised for registry development as these have the greatest impacts on patient morbidity, mortality and quality of life. Sub-optimal outcomes may also result in repeat hospitalisations and increased use of healthcare resources. This criterion was used to rank domains in terms of priority. 1.2 An evidence-based, well executed sequence of care improves patient outcomes for the clinical condition. Threshold The core purpose of clinical quality registries is to identify and address unwarranted variation from defined sequences of care. Where no evidence-based sequence of care has been defined, registries will be unable to collect longitudinal health outcome data for the eligible patient population and generate risk-adjusted reports on the appropriateness and effectiveness of health care. In some cases, the sequence of care for a clinical condition is articulated in clinical practice guidelines. Other clinical conditions may not have clinical practice guidelines that describe the appropriate sequence of care; however a well-executed sequence of care has been shown to influence patient outcomes. The importance of this criterion to the utility of a clinical quality registry was confirmed by a number of workshop participants. Where no evidence of a well-executed sequence of care was found in the literature or the existence of a functional clinical quality registry (national or international) shortlisted domains were excluded from further prioritisation. Domains that do not meet this criterion may benefit from research, epidemiological or other types of registries to improve understanding of the incidence and illness trajectory of clinical conditions and develop an evidence-based sequence of care. 1.3 Unwarranted variation from this sequence of care can be identified and addressed. Threshold Some clinical conditions may have a sequence of care, but unwanted variation from this sequence of care can be difficult to identify and/or address. This can occur where a condition has a long illness
Prioritised-list-of-clinical-domains-for-clinical-quality-registry-development-Final-report-Nov-2016.docx