scholarly journals Development of quality indicators for departments of hospital-based physiotherapy: a modified Delphi study

2020 ◽  
Vol 9 (2) ◽  
pp. e000812
Author(s):  
Rudi A Steenbruggen ◽  
Roel van Oorsouw ◽  
Marjo Maas ◽  
Thomas J Hoogeboom ◽  
Paul Brand ◽  
...  
Keyword(s):  
Quality Management ◽  
Focus Groups ◽  
Quality Indicators ◽  
Delphi Study ◽  
Composite Indicators ◽  
Hospital Policy ◽  
Physiotherapy Department ◽  
Modified Delphi ◽  
Starting Point ◽  
Delphi Procedure

BackgroundInternational hospital accreditation instruments, such as Joint Commission International (JCI) and Qmentum, focus mainly on hospital policy and procedures and do not specifically cover a profession such as hospital-based physiotherapy. This justifies the need for a quality system to which hospital-based physiotherapy can better identify, based on a common framework of quality indicators for effective quality management.ObjectiveThis study aimed to identify the most important quality indicators of a hospital-based physiotherapy department in the eyes of hospital-based physiotherapists and their managers.MethodsBased on input from three focus groups and a structured literature review, a first set of quality indicators for hospital physiotherapy was assembled. After checking this set for duplicates and for overlap with JCI and Qmentum, it formed the starting point of a modified Delphi procedure. In two rounds, 17 hospital-based physiotherapy experts rated the quality indicators on relevance through online surveys. In a final consensus meeting, quality indicators were established, classified in quality themes and operationalised by describing for each theme the rationale, specifications, domain and type of indicator.ResultsThree focus groups provided 120 potential indicators, which were complemented with 18 potential indicators based on literature. After duplicate and overlap check and the Delphi procedure, these 138 potential indicators were reduced to a set of 56 quality indicators for hospital-based physiotherapy. Finally, these 56 indicators were condensed into 7 composite indicators, each representing a quality theme based on definitions of the European Foundation for Quality Management.ConclusionA set of 56 quality indicators, condensed into 7 composite indicators each representing a quality theme, was developed to assess the quality of a hospital-based physiotherapy department.

scholarly journals Quality indicators for Palliative Day Services: A modified Delphi study

2018 ◽  
Vol 33 (2) ◽  
pp. 197-205 ◽  
Author(s):  
Noleen K McCorry ◽  
Sean O’Connor ◽  
Kathleen Leemans ◽  
Joanna Coast ◽  
Michael Donnelly ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Indicators ◽  
Delphi Study ◽  
Service Providers ◽  
Panel Discussion ◽  
Unmet Need ◽  
Modified Delphi ◽  
Starting Point ◽  
Day Services

Background: The goal of Palliative Day Services is to provide holistic care that contributes to the quality of life of people with life-threatening illness and their families. Quality indicators provide a means by which to describe, monitor and evaluate the quality of Palliative Day Services provision and act as a starting point for quality improvement. However, currently, there are no published quality indicators for Palliative Day Services. Aim: To develop and provide the first set of quality indicators that describe and evaluate the quality of Palliative Day Services. Design and setting: A modified Delphi technique was used to combine best available research evidence derived from a systematic scoping review with multidisciplinary expert appraisal of the appropriateness and feasibility of candidate indicators. The resulting indicators were compiled into ‘toolkit’ and tested in five UK Palliative Day Service settings. Results: A panel of experts independently reviewed evidence summaries for 182 candidate indicators and provided ratings on appropriateness, followed by a panel discussion and further independent ratings of appropriateness, feasibility and necessity. This exercise resulted in the identification of 30 indicators which were used in practice testing. The final indicator set comprised 7 structural indicators, 21 process indicators and 2 outcome indicators. Conclusion: The indicators fulfil a previously unmet need among Palliative Day Service providers by delivering an appropriate and feasible means to assess, review, and communicate the quality of care, and to identify areas for quality improvement.

scholarly journals Quality Indicators for Appropriate Outpatient Parenteral Antimicrobial Therapy in Adults: A Systematic Review and RAND-modified Delphi Procedure

2019 ◽  
Vol 70 (6) ◽  
pp. 1075-1082 ◽  
Author(s):  
Marvin A H Berrevoets ◽  
Jaap ten Oever ◽  
Anke J M Oerlemans ◽  
Bart Jan Kullberg ◽  
Marlies E Hulscher ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Indicators ◽  
Antimicrobial Therapy ◽  
Expert Panel ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Modified Delphi ◽  
Delphi Procedure ◽  
Antimicrobial Management ◽  
Patient Selection Criteria

Abstract Background Our aim in this study was to develop quality indicators (QIs) for outpatient parenteral antimicrobial therapy (OPAT) care that can be used as metrics for quality assessment and improvement. Methods A RAND-modified Delphi procedure was used to develop a set of QIs. Recommendations on appropriate OPAT care in adults were retrieved from the literature using a systematic review and translated into potential QIs. These QIs were appraised and prioritized by a multidisciplinary panel of international OPAT experts in 2 questionnaire rounds combined with a meeting between rounds. Results The procedure resulted in 33 OPAT-specific recommendations. The following QIs that describe recommended OPAT care were prioritized by the expert panel: the presence of a structured OPAT program, a formal OPAT care team, a policy on patient selection criteria, and a treatment and monitoring plan; assessment for OPAT should be performed by the OPAT team; patients and family should be informed about OPAT; there should be a mechanism in place for urgent discussion and review of emergent clinical problems, and a system in place for rapid communication; laboratory results should be delivered to physicians within 24 hours; and the OPAT team should document clinical response to antimicrobial management, document adverse events, and monitor QIs for OPAT care and make these data available. Conclusions We systematically developed a set of 33 QIs for optimal OPAT care, of which 12 were prioritized by the expert panel. These QIs can be used to assess and improve the quality of care provided by OPAT teams.

scholarly journals An Environmental Scan of Canadian Quality Metrics for Patients on In-Center Hemodialysis

2020 ◽  
Vol 7 ◽  
pp. 205435812097531
Author(s):  
Daniel Blum ◽  
Alison Thomas ◽  
Claire Harris ◽  
Jay Hingwala ◽  
William Beaubien-Souligny ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Quality Indicators ◽  
Quality Metrics ◽  
Care Quality ◽  
Environmental Scan ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Effective Care ◽  
Starting Point

Background: Quality metrics or indicators help guide quality improvement work by reporting on measurable aspects of health care upon which improvement efforts can focus. For recipients of in-center hemodialysis (ICHD) in Canada, it is unclear what ICHD quality indicators exist and whether they adequately cover different domains of health care quality. Objectives: To identify and evaluate current Canadian ICHD quality metrics to document a starting point for future collaborations and standardization of quality improvement in Canada. Design: Environmental scan of quality metrics in ICHD, and subsequent indicator evaluation using a modified Delphi approach. Setting: Canadian ICHD units. Participants: Sixteen-member pan-Canadian working group with expertise in ICHD and quality improvement. Measurements: We classified the existing indicators based on the Institute of Medicine (IOM) and Donabedian frameworks. Methods: Each metric was rated by a 5-person subcommittee using a modified Delphi approach based on the American College of Physicians/Agency for Healthcare Research and Quality criteria. We shared these consensus ratings with the entire 16-member panel for additional comments. Results: We identified 27 metrics that are tracked across 8 provinces, with only 9 (33%) tracked by multiple provinces (ie, more than 1 province). We rated 9 metrics (33%) as “necessary” to distinguish high-quality from low-quality care, of which only 2 were tracked by multiple provinces (proportion of patients by primary access and rate of vascular access-related bloodstream infections). Most (16/27, 59%) indicators assessed the IOM domains of safe or effective care, and none of the “necessary” indicators measured the IOM domains of timely, patient-centered, or equitable care. Limitations: The environmental scan is a nonexhaustive list of quality indicators in Canada. The panel also lacked representation from patients, administrators, and allied health professionals, with more representation from academic sites. Conclusions: Quality indicators in Canada mainly focus on safe and effective care, with little provincial overlap. These results highlight current gaps in quality of care measurement for ICHD, and this initial work should provide programs with a starting point to combine highly rated indicators with newly developed indicators into a concise balanced scorecard that supports quality improvement initiatives across all aspects of ICHD care. Trial Registration: not applicable.

scholarly journals Advancing the Development of Patient-reported Outcomes for Adult Myositis at OMERACT 2016: An International Delphi Study

2017 ◽  
Vol 44 (11) ◽  
pp. 1683-1687 ◽  
Author(s):  
Jin Kyun Park ◽  
Christopher A. Mecoli ◽  
Helene Alexanderson ◽  
Malin Regardt ◽  
Lisa Christopher-Stine ◽  
...  
Keyword(s):  
Focus Groups ◽  
Delphi Study ◽  
Patient Reported Outcomes ◽  
Qualitative Content Analysis ◽  
Healthcare Providers ◽  
The United States ◽  
Delphi Survey ◽  
Modified Delphi ◽  
Patient Reported ◽  
Pharmaceutical Industries

Objective.To define a set of core patient-reported domains and respective instruments for use in idiopathic inflammatory myopathies (IIM). Previously, we reported a systematic literature review on patient-reported outcomes (PRO) in IIM followed by conducting international focus groups to elicit patient perspectives of myositis symptoms and effects.Methods.Based on qualitative content analysis of focus groups, an initial list of 26 candidate domains was constructed. We subsequently conducted an international modified Delphi survey to identify the importance of each of the 26 domains. Participants were asked to rate each domain on a scale of 0–10 (0 = not important, 10 = very important).Results.In this first round of the Delphi survey, 643 patients participated from the United States (n = 543), Sweden (n = 49), and South Korea (n = 51). Of the 26 domains, 19 (73%) were rated of high importance (≥ 7/10). The top 5 domains were muscle symptoms, fatigue, interactions with healthcare, medication side effects, and pain. During Outcome Measures in Rheumatology (OMERACT) 2016, we discussed the goal for ultimate reduction in the number of domains and the importance of considering representation of healthcare providers from other specialties, caregivers, representatives of pharmaceutical industries, and regulatory authorities in the next rounds of Delphi to represent broader perspectives on IIM.Conclusion.Further prioritization and a reduction in the number of domains will be needed for the next Delphi. At the next biennial OMERACT meeting, we aim to present and seek voting on a Myositis Preliminary PRO Core Set to enable ultimate measure selection and development.

scholarly journals A Quality Scorecard for the Administration of Online Education Programs

2010 ◽  
Vol 14 (4) ◽  
Author(s):  
Kaye Shelton
Keyword(s):  
Higher Education ◽  
Online Education ◽  
Quality Indicators ◽  
Delphi Study ◽  
Higher Education Policy ◽  
Study Quality ◽  
Education Programs ◽  
Policy Study ◽  
Starting Point ◽  
Quality Scorecard

As the demands for public accountability increase for the higher education, institutions are seeking methods for continuous improvement in order to demonstrate quality within programs and processes, including those provided through online education. A six round Delphi study was undertaken with 43 seasoned administrators of online education programs who agreed upon 70 quality indicators that administrators should examine within their programs to evaluate quality. A method for scoring was also developed. The original set of quality indicators from the Institute for Higher Education Policy study, Quality on the Line: Benchmarks for Success in Internet-Based Distance Education (2000) were used as a starting point and determined still valid in 2010, with modifications. The study resulted in a quality scorecard for the administration of online education programs.

Quality indicators in the management of bladder cancer: A modified Delphi study

2017 ◽  
Vol 35 (6) ◽  
pp. 328-334 ◽  
Author(s):  
Satya R. Khare ◽  
Armen Aprikian ◽  
Peter Black ◽  
Normand Blais ◽  
Chris Booth ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Quality Indicators ◽  
Delphi Study ◽  
Modified Delphi

scholarly journals Development of quality indicators for the management of Staphylococcus aureus bacteraemia

2019 ◽  
Vol 74 (11) ◽  
pp. 3344-3351 ◽  
Author(s):  
Jaap ten Oever ◽  
Joëll L Jansen ◽  
Thomas W van der Vaart ◽  
Jeroen A Schouten ◽  
Marlies E J L Hulscher ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Staphylococcus Aureus ◽  
Quality Indicators ◽  
Hospitalized Patients ◽  
Source Control ◽  
Recommended Care ◽  
Face To Face ◽  
Modified Delphi ◽  
Delphi Procedure

Abstract Background Staphylococcus aureus bacteraemia (SAB) is a serious and often fatal infectious disease. The quality of management of SAB is modifiable and can thus affect the outcome. Quality indicators (QIs) can be used to measure the quality of care of the various aspects of SAB management in hospitals, enabling professionals to identify targets for improvement and stimulating them to take action. Objectives To develop QIs for the management of hospitalized patients with SAB. Methods A RAND-modified Delphi procedure was used to develop a set of QIs for the management of SAB in hospitalized patients. First, available QIs for the management of SAB were extracted from the literature published since 1 January 2000 (MEDLINE and Embase databases). Thereafter, an international multidisciplinary expert panel appraised these QIs during two questionnaire rounds with an intervening face-to-face meeting. Results The literature search resulted in a list of 39 potential QIs. After appraisal by 30 medical specialists, 25 QIs describing recommended care at patient level were selected. These QIs defined appropriate follow-up blood cultures (n=2), echocardiography (n=6), source control (n=4), antibiotic therapy (n=7), antibiotic dose adjustment (n=2), intravenous-to-oral switch (n=2), infectious disease consultation (n=1) and medical discharge report (n=1). Conclusions A set of 25 QIs for the management of SAB for hospitalized patients was developed by using a RAND-modified Delphi procedure among international experts. These QIs can measure the quality of various aspects of SAB management. This information can be fed back to the relevant stakeholders in order to identify improvement targets and optimize care.

Sign in / Sign up

Export Citation Format

Share Document