Stroke care

A method for measuring compliance with AHCPR guidelines

Barbara J. LaClair, Dean M. Reker*, Pamela W. Duncan, Ronnie D. Horner, Helen Hoenig

*Corresponding author for this work

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

The purpose of this article is to describe a method for converting practice guidelines to measurement criteria. To evaluate the processes of care received by patients with stroke at 11 Veteran's Administration hospital sites, we developed a measurement system based on Agency for Health Care Policy and Research (AHCPR) Post-Stroke Rehabilitation Clinical Practice Guidelines. Guideline recommendations were used as the framework for identifying important dimensions of care, and for developing chart abstraction instruments for both the acute and postacute settings. Using a modified Delphi technique to solicit opinions from an expert panel, a method was developed for aggregation of item-level chart abstraction components to overall guideline compliance scores. The measurement system was shown to have good-to-excellent intrarater and interrater reliability at the item, dimension, and overall compliance score levels. Abstraction of a sample of 100 medical records demonstrated the ability of the instruments to detect variability in processes of post-stroke care. This study provides the foundation for future research, which will evaluate associations between processes of post-stroke care, as measured by this medical chart abstraction system, and patient outcomes.

Original languageEnglish
Pages (from-to)235-242
Number of pages8
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume80
Issue number3
DOIs
Publication statusPublished - 2001
Externally publishedYes

Keywords

  • Cerebrovascular Disorders
  • Clinical Practice Guidelines
  • Process Assessment (Healthcare)
  • Rehabilitation

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