Table 4.
Domains and indicators of quality in headache service delivery (from [5])
| Domain A. Accurate diagnosis is essential for optimal headache care | |
| A1 | Patients are asked about onset of their headaches |
| A2 | Diagnosis is according to current ICHD criteria |
| A3 | A working diagnosis is made at the first visit |
| A4 | A definitive diagnosis is made at first or subsequent visit |
| A5 | Diagnosis is reviewed during later follow-up |
| A6 | Diaries are used to support or confirm diagnosis |
| Domain B. Individualized management is essential for optimal headache care | |
| B1 | Waiting-list times for appointments are related to urgency of need |
| B2 | Sufficient time is allocated to each visit for the purpose of good management |
| B3 | Patients are asked about the temporal profile of their headaches |
| B4 | Treatment plans follow evidence-based guidelines, reflecting diagnosis |
| B5 | Treatment plans include psychological approaches to therapy when appropriate |
| B6 | Treatment plans reflect disability assessment |
| B7 | Patients are followed up to ascertain optimal outcome |
| Domain C. Appropriate referral pathways are essential for optimal headache care | |
| C1 | Referral pathway is available from primary to specialist care |
| C2 | Urgent referral pathway is available when necessary |
| Domain D. Education of patients about their headaches and their management is essential for optimal headache care | |
| D1 | Patients are given the information they need to understand their headache and its management |
| D2 | Patients are given appropriate reassurance |
| Domain E. Convenience and comfort are part of optimal headache care | |
| E1 | The service environment is clean and comfortable |
| E2 | The service is welcoming |
| E3 | Waiting times in the clinic are acceptable to both health-care providers and patients |
| Domain F. Achieving patient satisfaction is part of optimal headache care | |
| F1 | Patients are satisfied with their management |
| Domain G. Optimal headache care is efficient and equitable | |
| G1 | Procedures are followed to ensure resources are not wasted |
| G2 | Patients are not over-investigated |
| G3 | Costs of the service are measured as part of a cost-effectiveness policy |
| G4 | There is equal access to headache services for all who need it |
| Domain H. Outcome assessment is essential in optimal headache care | |
| H1 | Outcome measures are based on self-reported symptom burden (headache frequency, duration and intensity) |
| H2 | Outcome measures are based on self-reported disability burden |
| H3 | Outcome measures are based on self-reported quality of life |
| Domain I. Optimal headache care is safe | |
| I1 | Patients are not over-treated |
| I2 | Systems are in place to be aware of serious adverse events |