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Use of information technology to monitor the quality of healthcare in services of cardiac pacing from the State of São Paulo

Grant number: 19/09155-3
Support type:Regular Research Grants
Duration: February 01, 2020 - January 31, 2022
Field of knowledge:Health Sciences - Medicine
Principal Investigator:Roberto Costa
Grantee:Roberto Costa
Home Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
Assoc. researchers: Caio Marcos de Moraes Albertini ; Elizabeth Sartori Crevelari ; Katia Regina da Silva ; Marcia Mitie Nagumo

Abstract

Purpose of Study: In recent years, many initiatives have been made to improve the quality and efficiency of healthcare services leading to the creation and standardization of health quality indicators in order to improve the interaction between clinicians, researchers, and healthcare managers, enabling the generation of evidence-based strategies. Therefore, our goal is to implement a prospective and multicenter registry of cardiac implantable electronic devices (CIED) using cutting-edge technologies to ensure the quality of data collection and management according to international standards, aiming to monitor real-time quality indicators of specialized hospitals in Cardiac Pacing from the State of Sao Paulo.Methods: This is a prospective and multicenter registry with data derived from real-world clinical practice. Data will be collected in three different moments: (1) Index hospitalization, which refers to the episode of the surgical procedure (new implantation or reoperation); (2) 30-days after discharge, and (3) 1-year after the surgical procedure. Nine specialized hospitals in Cardiac Pacing from the state of São Paulo will participate in this project. Delphi method will be used to define the healthcare quality indicators, considering the opinion of cardiac pacing experts. Basically, the quality indicators approach will focus on the following components: (1) Structure measures: infrastructure, staff and organizational resources; (2) Process measures: healthcare practices and service routines; (3) Outcome measures: the impact of the care on different clinical outcomes; (4) Patient reported outcomes: quality of life and satisfaction with hospital healthcare services. Data will be collected directly from patients' records and hospital administrative databases using REDCap (Research Electronic Data Capture) system. The quality indicators will be monitored in real-time through "Interactive Dashboards", which will be developed during the present proposal after the process of data aggregation. Quality indicators of each Cardiac Pacing Hospital will be individually compared (internal benchmark), and then compared to the average of all centers (comparative benchmark). In the same proposal, prediction models for mortality and hospital readmissions will be developed by using machine learning techniques. The information generated from these models will support the development of future decision models.Expected results: Upon completion of this project, we will have a robust infrastructure for electronic data collection and research data management focused on quality indicators of Cardiac Pacing Hospitals that would allow the creation of a national network in this area. In fact, this infrastructure will be of great value to drive innovation, research, efficiency and the quality of services provided. More importantly, this infrastructure may be later transferable to other healthcare areas, allowing greater rationality to the use of resources and improving the quality of care provided to our patients. (AU)