Are we delivering optimal pulmonary rehabilitation? The importance of quality indicators in evaluating clinical practice

Abstract

Pulmonary rehabilitation (PR) is a complex intervention that has been shown to improve exercise capacity and quality of life, reduce dyspnea, and decrease the risk of exacerbations and hospitalization. Although the evidence for PR is strong, the translation of this evidence into clinical practice remains a challenge, and important gaps in care exist. To date, most research in PR has focused on questions related to treatment efficacy. Less attention has been paid to confirming whether the strong evidence base of PR has been effectively translated to this complex clinical setting. Policy makers and other stakeholders in PR are calling for the establishment of core standards and quality indicators in PR to evaluate existing programs and improve patient care. However, what are quality indicators, and how are they used? This Perspective explores quality assurance in the context of PR and introduces the concepts and uses of quality indicators that can be used to evaluate and improve the quality of care.