Dataset Information

Development of a quality indicator set to measure and improve quality of ICU care for patients with traumatic brain injury.

ABSTRACT: BACKGROUND:We aimed to develop a set of quality indicators for patients with traumatic brain injury (TBI) in intensive care units (ICUs) across Europe and to explore barriers and facilitators for implementation of these quality indicators. METHODS:A preliminary list of 66 quality indicators was developed, based on current guidelines, existing practice variation, and clinical expertise in TBI management at the ICU. Eight TBI experts of the Advisory Committee preselected the quality indicators during a first Delphi round. A larger Europe-wide expert panel was recruited for the next two Delphi rounds. Quality indicator definitions were evaluated on four criteria: validity (better performance on the indicator reflects better processes of care and leads to better patient outcome), feasibility (data are available or easy to obtain), discriminability (variability in clinical practice), and actionability (professionals can act based on the indicator). Experts scored indicators on a 5-point Likert scale delivered by an electronic survey tool. RESULTS:The expert panel consisted of 50 experts from 18 countries across Europe, mostly intensivists (N?=?24, 48%) and neurosurgeons (N?=?7, 14%). Experts agreed on a final set of 42 indicators to assess quality of ICU care: 17 structure indicators, 16 process indicators, and 9 outcome indicators. Experts are motivated to implement this finally proposed set (N?=?49, 98%) and indicated routine measurement in registries (N?=?41, 82%), benchmarking (N?=?42, 84%), and quality improvement programs (N?=?41, 82%) as future steps. Administrative burden was indicated as the most important barrier for implementation of the indicator set (N?=?48, 98%). CONCLUSIONS:This Delphi consensus study gives insight in which quality indicators have the potential to improve quality of TBI care at European ICUs. The proposed quality indicator set is recommended to be used across Europe for registry purposes to gain insight in current ICU practices and outcomes of patients with TBI. This indicator set may become an important tool to support benchmarking and quality improvement programs for patients with TBI in the future.

SUBMITTER: Huijben JA

PROVIDER: S-EPMC6431034 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Development of a quality indicator set to measure and improve quality of ICU care for patients with traumatic brain injury.

Huijben Jilske A JA Wiegers Eveline J A EJA de Keizer Nicolette F NF Maas Andrew I R AIR Menon David D Ercole Ari A Citerio Giuseppe G Lecky Fiona F Wilson Lindsay L Cnossen Maryse C MC Polinder Suzanne S Steyerberg Ewout W EW van der Jagt Mathieu M Lingsma Hester F HF

Critical care (London, England) 20190322 1

<h4>Background</h4>We aimed to develop a set of quality indicators for patients with traumatic brain injury (TBI) in intensive care units (ICUs) across Europe and to explore barriers and facilitators for implementation of these quality indicators.<h4>Methods</h4>A preliminary list of 66 quality indicators was developed, based on current guidelines, existing practice variation, and clinical expertise in TBI management at the ICU. Eight TBI experts of the Advisory Committee preselected the quality ...[more]

PMID: 30902117

Similar Datasets

Project description:PurposeTo develop a set of actionable quality indicators for critical care suitable for use in low- or middle-income countries (LMICs).MethodsA list of 84 candidate indicators compiled from a previous literature review and stakeholder recommendations were categorised into three domains (foundation, process, and quality impact). An expert panel (EP) representing stakeholders from critical care and allied specialties in multiple low-, middle-, and high-income countries was convened. In rounds one and two of the Delphi exercise, the EP appraised (Likert scale 1-5) each indicator for validity, feasibility; in round three sensitivity to change, and reliability were additionally appraised. Potential barriers and facilitators to implementation of the quality indicators were also reported in this round. Median score and interquartile range (IQR) were used to determine consensus; indicators with consensus disagreement (median < 4, IQR ≤ 1) were removed, and indicators with consensus agreement (median ≥ 4, IQR ≤ 1) or no consensus were retained. In round four, indicators were prioritised based on their ability to impact cost of care to the provider and recipient, staff well-being, patient safety, and patient-centred outcomes.ResultsSeventy-one experts from 30 countries (n = 45, 63%, representing critical care) selected 57 indicators to assess quality of care in intensive care unit (ICU) in LMICs: 16 foundation, 27 process, and 14 quality impact indicators after round three. Round 4 resulted in 14 prioritised indicators. Fifty-seven respondents reported barriers and facilitators, of which electronic registry-embedded data collection was the biggest perceived facilitator to implementation (n = 54/57, 95%) Concerns over burden of data collection (n = 53/57, 93%) and variations in definition (n = 45/57, 79%) were perceived as the greatest barrier to implementation.ConclusionThis consensus exercise provides a common set of indicators to support benchmarking and quality improvement programs for critical care populations in LMICs.

Dataset Information

Development of a quality indicator set to measure and improve quality of ICU care for patients with traumatic brain injury.

Publications

Development of a quality indicator set to measure and improve quality of ICU care for patients with traumatic brain injury.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets