Developing a set of indicators to monitor quality in ambulatory diabetes care using a modified Delphi panel process.
Int J Qual Health Care
; 30(1): 65-74, 2018 Feb 01.
Article
em En
| MEDLINE
| ID: mdl-29340632
ABSTRACT
OBJECTIVE:
There is a large evidence to practice gap in diabetes care with limited performance assessments that capture the full spectrum of care delivery. Our study aimed to develop a set of ambulatory diabetes quality indicators across six domains (effectiveness, safety, patient-centered, timely, equitable and efficient) to provide a broad view of quality.DESIGN:
A modified Delphi panel process was conducted. Phase I involved compiling a list of indicators through literature review and generation of patient and healthcare provider-derived indicators through interviews and surveys, respectively. Phase II involved panelists rating indicators using the Agency for Healthcare Research and Quality measure attributes on 9-point Likert scale, attending a face-to-face meeting followed by re-rating, and final ranking.SETTING:
This study was conducted across five adult academic medical centers affiliated with the University of Toronto.PARTICIPANTS:
A multi-disciplinary Delphi panel (n = 16) including patients was assembled. MAIN OUTCOMEMEASURE:
For indicator advancement for ranking, ≥75% of panelists' responses in the top tertile (between 7 and 9) with a median composite score of ≥7 was required.RESULTS:
There were 202 indicators included in the Delphi panel process including 171 from a comprehensive literature review, 14 from patient interviews, and 17 from healthcare provider surveys. Following the first round, 40 indicators proceeded directly to ranking, while 162 indicators were re-rated and distilled down to 12 for ranking. In the final ranking round, the 52 indicators were reduced to 35 including 13 effective, 10 safe, 6 patient-centered, 1 equitable, 3 efficient and 2 timely indicators.CONCLUSION:
Thirty-five selected indicators developed with broad stakeholder engagement can be used to monitor quality in diabetes care.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Indicadores de Qualidade em Assistência à Saúde
/
Diabetes Mellitus
/
Assistência Ambulatorial
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article