A model for the development and implementation of a national plan for the optimal management of early spondyloarthritis: the Esperanza Program

Ann Rheum Dis. 2011 May;70(5):827-30. doi: 10.1136/ard.2010.141200. Epub 2011 Jan 17.

Abstract

Objectives: To evaluate the performance of a healthcare programme in early spondyloarthritis (SpA).

Methods: Based on previous analyses and expectations of a nominal group, the following were set: (1) minimum standards to create early SpA units; (2) standard operating procedures; and (3) eight performance indicators that can be measured in real time using a web-based platform.

Results: At the end of the evaluation of the programme the expected level of performance was achieved in three of the indicators: 'referral reliability' (standard (S) >50%, real value (RV) 92%), 'accessibility' (S >90%, RV=91%) and 'duration of first visit' (S >50%, RV=53%). The performance in the remaining indicators was inferior: 'success of referral criteria' (S >50%, RV=28%), 'clinical reports issued' (S >90%, RV=25%), 'feedback guarantee' (S >85%, RV=2%), 'missing data' (S <10%, RV=24%) and 'frequency of review' (S >90%, RV=84%). Explanations for the low performance are provided.

Conclusions: It is possible to implement a large-scale programme that is measurable.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Delivery of Health Care / organization & administration
  • Delivery of Health Care / standards
  • Early Diagnosis
  • Health Plan Implementation*
  • Health Services Research / methods
  • Humans
  • Models, Organizational*
  • National Health Programs / organization & administration*
  • Program Evaluation
  • Quality Indicators, Health Care
  • Referral and Consultation / standards
  • Spain
  • Spondylarthritis / diagnosis
  • Spondylarthritis / therapy*