title: [Preliminary results of the Spanish Society of Nephrology multicenter study of quality performance measures: hemodialysis outcomes can be improved].
abstract: BACKGROUND
  The Spanish Society of Nephrology "Quality in Nephrology Working Group" (QNWG) was created in 2002. The aims of this group are the identification, diffusion, implementation and consolidation of a systematic, objective and comprehensive set of quality performance measures (QPMs) to help along the improvement of patient care and outcomes on hemodialysis, by means of strategies of feedback and benchmarking, and the design of quality improvement projects. The objective of this study is to present the preliminary results of a set of quality performance measures obtained in a group of Spanish hemodialysis centers, as well as to evaluate the repercussion of the application of the aforementioned thecniques on the observed results.
  
  
  METHODS
  During 2007 a total of 28 hemodialysis units participated in the study; 2516 patients were evaluated. A specific software was designed and used to facilitate the calculation of CPMs in each unit. The clinical indicators used refered to dialysis adequacy; anemia; mineral metabolisme; nutrition; viral infections; vascular access; mortality, morbidity (number and days of hospital admissions); and renal transplant. Every three months each center received its own data and its comparison with the rest of the group.
  
  
  RESULTS
  Except for hemoglobin levels we observed a global improvement. The percentage of centers reaching the stablished standards defined by the QNWG passed from 65% to 90,9% for Kt/V Daugirdas II (> 1,3 in > that 80% of the patients); from 71,4 % to 77,2 % for PTH (> 30 % of patients with serum PTH between 150 and 300 pg/ml); and from 42,8 % to 63,5 % for phosphate (> 75 % of patients with a serum phsphate < 5,5 mg/dl). More than 50% of centers showed an improvement in their final results as compared with their own initial results in all analyzed CPMs. Those centers that did not obtained an improvement in their results started the study with better percentages of acomplishment than those that showed a significant improvement in QPMs. (80,6+/-15,4 versus 71,8+/-16,6 respectively; p<0,001)
  
  
  CONCLUSIONS
  We are starting to make progresses in our knowledge of clinical results in our hemodialysis units, although there is still a long way to go over. To monitor and share CPMs results within hemodialysis centers might help to improve their results as well as to reduce intecenters variability.
authors.affiliation: Hospital 12 de octubre, Madrid.
authors.forename: J M
authors.initials: JM
authors.lastname: Alcázar
authors.forename: M D
authors.initials: MD
authors.lastname: Arenas
authors.forename: F
authors.initials: F
authors.lastname: Alvarez-Ude
authors.forename: R
authors.initials: R
authors.lastname: Virto
authors.forename: E
authors.initials: E
authors.lastname: Rubio
authors.forename: F
authors.initials: F
authors.lastname: Maduell
authors.forename: P
authors.initials: P
authors.lastname: Fernández-Crespo
authors.forename: M
authors.initials: M
authors.lastname: Angoso de Guzmán
authors.forename: R
authors.initials: R
authors.lastname: Delgado
authors.forename: C
authors.initials: C
authors.lastname: Santamaría
authors.forename: M A
authors.initials: MA
authors.lastname: Alonso
authors.forename: S
authors.initials: S
authors.lastname: Anaya
authors.forename: A
authors.initials: A
authors.lastname: Bordils
authors.forename: A
authors.initials: A
authors.lastname: Antolín
authors.forename: E
authors.initials: E
authors.lastname: González-Parra
authors.forename: I
authors.initials: I
authors.lastname: Pérez
authors.forename: A
authors.initials: A
authors.lastname: Molina Ordás
authors.forename: M
authors.initials: M
authors.lastname: Fernández
authors.forename: P
authors.initials: P
authors.lastname: Molina
authors.forename: P
authors.initials: P
authors.lastname: Sánchez
authors.forename: F
authors.initials: F
authors.lastname: Barbosa
authors.forename: L
authors.initials: L
authors.lastname: Palomares Solla
authors.forename: J
authors.initials: J
authors.lastname: Lacueva
authors.forename: G
authors.initials: G
authors.lastname: Barril
authors.forename: J M
authors.initials: JM
authors.lastname: Pastor
authors.forename: C
authors.initials: C
authors.lastname: Gámez Matías
authors.forename: P Mateos
authors.initials: PM
authors.lastname: Hernández
authors.forename: M Fulquet
authors.initials: MF
authors.lastname: Nicolás
authors.forename: F
authors.initials: F
authors.lastname: Ríos
mesh_terms: D006801:Humans; D017063:Outcome Assessment, Health Care; D011787:Quality of Health Care / Q000592:standards*; D006435:Renal Dialysis / Q000592:standards*; D013030:Spain