Selection of Quality Indicators to Evaluate Quality of Care for Patients with Esophageal Atresia Using a Delphi Method

IF 1.5 3区 医学 Q2 PEDIATRICS
Nadine M. Teunissen, Julia Brendel, L.W Ernest van Heurn, Benno Ure, Rene Wijnen, Simon Eaton, on behalf of the EPSA|ERNICA Registry Group, the EA Quality of Care Initiative
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引用次数: 0

Abstract

Objective Survival of neonates with esophageal atresia (EA) is relatively high and stable, resulting in increased attention to optimizing care and longer-term morbidity. This study aimed to reach consensus on a quality indicator set for benchmarking EA care between hospitals, regions, or countries in a European clinical audit.

Methods Using an online Delphi method, a panel of EA health care professionals and patient representatives rated potential outcome, structure, and process indicators for EA care identified through systematic literature and guideline review on a nine-point Likert scale in three questionnaires. Items were included based on predefined criteria. In rounds 2 and 3, participants were asked to select the five to ten most essential of the included indicators.

Results An international panel of 14 patient representatives and 71 multidisciplinary health care professionals representing 41 European hospitals completed all questionnaires (response rate: 81%), eventually including 22 baseline characteristics and 32 indicators. After ranking, 10 indicators were prioritized by both stakeholder groups. In addition, each stakeholder group highly prioritized one additional indicator. Following an additional online vote by the other group, these were both added to the final set.

Conclusion This study established a core indicator set of twenty-two baseline characteristics, eight outcome indicators, one structure indicator, and three process indicators for evaluating (quality of) EA care in Europe. These indicators, covering various aspects of EA care, will be implemented in the European Pediatric Surgical Audit to enable recognition of practice variation and focus EA care improvement initiatives.

用德尔菲法选择评价食道闭锁患者护理质量的质量指标
目标 食管闭锁(EA)新生儿的存活率相对较高且稳定,因此人们越来越关注优化护理和长期发病率。本研究旨在就一套质量指标达成共识,以便在欧洲临床审核中为不同医院、地区或国家之间的食管闭锁护理设定基准。方法 由EA医护人员和患者代表组成的小组采用在线德尔菲法,在三份问卷中以九分李克特量表对通过系统文献和指南审查确定的EA护理潜在结果、结构和流程指标进行评分。项目根据预定义标准纳入。在第二轮和第三轮中,要求参与者从所包含的指标中选出五到十个最重要的指标。结果 由代表欧洲 41 家医院的 14 名患者代表和 71 名多学科医护人员组成的国际小组完成了所有问卷(回复率:81%),最终包括 22 项基线特征和 32 项指标。经过排序,10 项指标被两个利益相关群体列为优先指标。此外,每个利益相关者小组还高度优先考虑了另外一项指标。在另一组进行了额外的在线投票后,这两个指标都被添加到了最终的指标集中。结论 本研究确立了一套核心指标,包括 22 个基线特征、8 个结果指标、1 个结构指标和 3 个过程指标,用于评估欧洲的紧急护理(质量)。这些指标涵盖了 EA 护理的各个方面,将在欧洲小儿外科审计中实施,以便识别实践中的差异,并关注 EA 护理改进措施。
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来源期刊
CiteScore
3.90
自引率
5.60%
发文量
66
审稿时长
6-12 weeks
期刊介绍: This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.
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