Table 3.
Suggested assessment template
| Standard | Criterion | Verification | Target | |
|---|---|---|---|---|
| Domain A. Competence of staff | ||||
| 1 | Centre is staffed by headache specialists, who are sufficient but not excessive in number. |
Each “headache specialist” can document:(a) advanced training (yes/no); (b) past and continuing experience in the field of headache (yes/no). Number of specialists is: (c) sufficient (yes/no); (d) not excessive (yes/no). |
(a, b) internal audit of CVs and continuing professional development records; (c, d) internal audit of workload and waiting times |
(a) 100% yes (b) 100% yes (c) aspirational (d) yes |
| Domain B. Provision of care | ||||
| 2 | Centre provides dedicated care for headache patients. | Patients with headache are seen in dedicated sessions, not within general neurological or other sessions (yes/no) | internal audit of clinic lists | yes as a general rule |
| 3 | Centre provides patients with a clear diagnosis made at earliest opportunity, information about their headache(s), advice on management and internationally-accepted evidence-based treatment. |
(a) Diagnoses are always according to ICHD-3 (yes/no). Disability assessments, diagnostic and follow-up diaries, outcome measures and patient information leaflets are: (b) all available (yes/no): (c) all routinely used (yes/no). (d) National or international management guidelines are adopted (yes/no). |
(a) internal audit of patients’ records; (b) objectively verifiable; (c) internal audit of patients’ records; (d) objectively verifiable |
(a) 100% yes (b) yes (c) yes (d) yes |
| 4 | Centre provides multidisciplinary care full-time, and competently manages disorders underlying the full range of secondary headaches. |
(a) Working collaborations exist between physicians, nurses, physical therapists and psychologists (yes/no). (b) The centre is based within, or in geographical proximity to, a general hospital providing access to emergency department, neurology, neuroradiology, neurosurgery, psychiatry, ophthalmology, otorhinolaryngology, orthopaedics, rheumatology, cardiology, infectious diseases, endocrinology, paediatrics, gynaecology, dentistry (yes/no). (c) Inpatient facilities are available for patients with certain comorbidities and for those needing supervised withdrawal from medication overuse (yes/no). |
(a) existence is objectively verifiable; (b) access is objectively verifiable; (c) availability is objectively verifiable |
(a) yes (b) yes (c) yes |
| Domain C. Quality evaluation and assurance | ||||
| 5 | Centre monitors quality of care in order to optimize it. | Procedures are in place for recording clinical outcomes and adverse events, and service quality indicators (Table 4), with regular audits of all (yes/no). | objectively verifiable as present and happening | yes |
| Domain D. Networks and collaborations | ||||
| 6 | Centre maintains quality of endeavour through networking, collaboration and the sharing of experience with other international and/or national centres. |
(a) Existence and operation of networks and collaboration are documented by the centre (yes/no). (b) Evidence is presented of any of the following (yes/no): • exchange of ideas relating to service organization, patient care, teaching and/or research; • exchange of staff and/or engagement in a fellowship exchange programme; • collaborative research protocols; • shared or collaborative educational programmes; • shared or common database. |
(a, b) verifiable by peer review |
(a) yes (b) yes to one or more |
| Domain E. Teaching | ||||
| 7 | Centre is a principal resource for national postgraduate training in the field of headache. |
Evidence is presented of recent or current engagement in at least two of the following (yes/no): • development of national management guidelines, or adaptation of international guidelines for national use; • development of learning materials for trainee headache specialists, neurologists and/or specialist nurses; • delivery of didactic teaching and/or clinical demonstrations to trainee headache specialists, neurologists and/or specialist nurses on a regular basis; • acceptance of clinical trainees on accredited attachments. |
verifiable by peer review | yes to two or more |
| 8 | Centre provides support, through training and education, to health-care providers at levels 1 and 2. |
Either: (a) a programme of training and education is offered through formal links between the centre and health-care providers at levels 1 and 2 throughout the geographical area served by the centre (yes/no); (b) where levels 1 and 2 are not in place within structured services, a programme of training and education is continuously available to local general practitioners, nurses and/or pharmacists (yes/no) |
(a) objectively verifiable as in place; (b) verifiable by peer review |
yes to either |
| Domain F. Research | ||||
| 9 | Centre is a principal fount of useful research output in the field of headache. |
Research is either or both: (a) of international value (yes/no); (b) appropriate to the needs of the local community (yes/no). |
peer review of quantity, quality and value of publications | yes to either |
| Domain G. Empirical support of existence | ||||
| 10 | Centre supports and justifies its existence, and the development of others, by documenting and demonstrating its utility. |
Activities and achievements: (a) are documented (yes/no); (b) provide evidence of utility (yes/no). |
(a) objectively verifiable; (b) verifiable by peer review |
(a) yes (b) yes |