A model for the development and implementation of a national plan for the optimal management of early spondyloarthritis: the Esperanza Program.
OBJECTIVE
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.
Rheumatology Unit, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.
Santiago
S
Muñoz-Fernández
Loreto
L
Carmona
Eduardo
E
Collantes
Juan
J
Mulero
M Jesús
MJ
García-Yébenes
Eugenio
E
de Miguel
Raquel
R
Almodovar
Cristina
C
Fernández-Carballido
José Francisco García
JF
Llorente
Milena
M
Gobbo
D003695:Delivery of Health Care / Q000458:organization & administration / Q000592:standards; D042241:Early Diagnosis; D006284:Health Plan Implementation; D006302:Health Services Research / Q000379:methods; D006801:Humans; D017146:Models, Organizational; D009313:National Health Programs / Q000458:organization & administration*; D015397:Program Evaluation; D019984:Quality Indicators, Health Care; D012017:Referral and Consultation / Q000592:standards; D013030:Spain; D025241:Spondylarthritis / Q000175:diagnosis / Q000628:therapy*