Model of excellence in Rheumatology Day Hospitals in Spain: the HD-Reumatolex project.
OBJECTIVE
Biologics have shown greater efficacy than traditional treatments in patients with rheumatoid arthritis, although some cannot be administered on an outpatient basis. Day hospitalization requires the patient to attend the hospital for a few hours to receive those treatments that cannot be administered on an outpatient basis or that do not justify admission to hospital. Few studies have analyzed the situation of Rheumatology Day Hospitals (RDH) in Spain. The HD-Reumatolex project aims to evaluate the situation of Spanish RDHs in terms of strategy, training, management, and quality of care.


METHODS
The project was based on a "model of excellence in RDH" design, which made it possible to perform a comparative analysis (benchmarking) of 21 Rheumatology Departments. The 19 criteria evaluated were divided into 3 categories: Strategic processes, Key processes, and Support processes.


RESULTS
The lowest mean scores were recorded for follow-up of clinical practice guidelines/recommendations and existence of a quality plan (Strategic processes), criteria for training among RDH professionals (Support processes), and admission and discharge (Key processes). Five RDH achieved the benchmark when the position obtained by the RDH in Key processes was plotted against the one obtained in Strategic processes and Support processes. One RDH emerged as a clear leader in the comparison.


CONCLUSIONS
None of the RDH obtained the total maximum score at the category level or at the total results level, thus revealing room for improvement in the attainment of excellence for all the participating centers.
Servicio de Reumatología, Hospital Universitario y Politécnico La Fe, Facultad de Medicina, Universidad Católica de Valencia, Valencia, España. roman_jan@gva.es
José Andrés
JA
Román Ivorra
Raimon
R
Sanmarti
Eduardo
E
Collantes-Estévez
Luis
L
Carreño Pérez
Lourdes
L
Betegón
D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D019985:Benchmarking; D003631:Day Care, Medical / Q000458:organization & administration / Q000592:standards*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D012219:Rheumatology / Q000458:organization & administration; D013030:Spain; D011795:Surveys and Questionnaires
D018501:Antirheumatic Agents