Title
Establishing a paediatric critical care core quality measure set using a multistakeholder, consensus-driven process.
Link to article in PubMed
Author(s)
Schults, Jessica A
Charles, Karina R
Millar, Johnny
Rickard, Claire M
Chopra, Vineet
Lake, Anna
Gibbons, Kristen
Long, Debbie
Rahiman, Sarfaraz
Hutching, Katrina
Winderlich, Jacinta
Spotswood, Naomi E
Johansen, Amy
Pizimolas, Georgina A
Tu, Quyen
Waak, Michaela
Allen, Meredith
McMullan, Brendan
Hall, Lisa
Abstract
Monitoring healthcare quality is challenging in paediatric critical care due to measure variability, data collection burden, and uncertainty regarding consumer and clinician priorities.We sought to establish a core quality measure set that (i) is meaningful to consumers and clinicians and (ii) promotes alignment of measure use and collection across paediatric critical care.We conducted a multi-stakeholder Delphi study with embedded consumer prioritisation survey. The Delphi involved two surveys, followed by a consensus meeting. Triangulation methods were used to integrate survey findings prior tobefore the consensus meeting. In the consensus panel, broad agreement was reached on a core measure set, and recommendations were made for future measurement directions in paediatric critical care.Australian and New Zealand paediatric critical care survivors (aged >18 years) and families were invited to rank measure priorities in an online survey distributed via social media and consumer groups. A concurrent Delphi study was undertaken with paediatric critical care clinicians, policy makers, and a consumer representative.None.Priorities for quality measures.Respondents to the consumer survey (n = 117) identified (i) nurse-patient ratios; (ii) visible patient goals; and (iii) long-term follow-up as their quality measure priorities. In the Delphi process, clinicians (Round 1 n = 191; Round 2 n = 117 [61% retention]; Round 3 n = 14) and a consumer representative reached broad agreement on a 51-item (61% of 83 initial measures) core measure set. Clinician priorities were (i) nurse-patient ratio; (ii) staff turnover; and (iii) long term-follow up. Measure feasibility was rated low due to a perceived lack of standardised case definitions or data collection burden. Five recommendations were generated.We defined a 51-item core measurement set for paediatric critical care, aligned with clinician and consumer priorities. Next steps are implementation and methodological evaluation in quality programs, and where appropriate, retirement of redundant measures.
Publication information
Crit Care Resusc . 2024 Mar 25;26(2):71-79. doi: 10.1016/j.ccrj.2024.01.002. eCollection 2024 Jun.
Date Issued
2024-03-25
Type
Journal Article
Journal Title
Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine
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