Affiliations: [a] Department of Epidemiology and Preventive Medicine, Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| [b] Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, Australia
Correspondence:
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Correspondence to: Dr. Darshini Ayton, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne 3004, Australia. Tel.: +61 3 9903 1660; E-mail: Darshini.Ayton@monash.edu.
Abstract: Background:A clinical quality registry (CQR) for dementia provides benefits to those living with dementia and their carers by improving the quality and experience of care through benchmarking and monitoring patient outcomes. CQRs use data collected to form clinical quality indicators (CQIs) through which variations in clinical processes and outcomes between different services and jurisdictions can be highlighted. Objective:This modified Delphi study aimed to develop CQIs for a pilot Australian CQR for dementia and mild cognitive impairment. These CQIs are based on evidence, patient and caregiver experience, and clinician perspectives across the trajectory of care from diagnosis to end-of-life. Methods:An initial list of indicators from existing dementia registries, academic literature, and clinical practice guidelines was synthesized. A working group of clinicians and registry experts further refined these indicators. A panel of experts comprised of a consumer, a carer, clinicians, consumer organization representatives, and academics. The experts participated in three phases of the modified Delphi study: 1) online survey for scoring importance and validity, 2) a one-day face-to-face discussion, and 3) final survey round to assess importance, validity, and feasibility. Results:The panel assessed 33 CQIs and confirmed a final set of 18 indicators. The CQIs mapped to the domains of quality of diagnosis, quality of management, access to services and supports, and potentially preventable complications. These CQIs will be tested initially in memory clinics and inform the data collection processes for the Australia Dementia Network Registry (ADNet). Conclusion:A dementia CQR is fundamental to ongoing monitoring and development of good quality and consistent care across Australia.
Keywords: Alzheimer’s disease, clinical quality registry, dementia, modified Delphi study
