Inge Hommel1, Petra J van Gurp2, Cees J Tack2, Hub Wollersheim1, Marlies Ejl Hulscher1. 1. Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands. 2. Department of General Internal Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
Abstract
BACKGROUND: In this study, we aim to develop a set of quality indicators for optimal perioperative diabetes care throughout the hospital care pathway and to gain insight into the feasibility of the indicator set in daily clinical practice by assessing the clinimetric properties of the indicators in a practice test. METHODS: A literature-based modified Delphi method was used to develop a set of quality indicators. To assess clinimetric properties of each indicator (measurability, applicability, reliability, improvement potential and case-mix stability), a practice test was performed in six Dutch hospitals using a sample of 389 major surgery patients with diabetes who underwent abdominal, cardiac or large joint orthopaedic surgery. RESULTS: We developed a set of 36 quality indicators for perioperative diabetes care. The practice test showed that one indicator was inapplicable, and nine indicators were unmeasurable. Interobserver reliability was good (0.61≤k≤0.8) for all indicators except for one with moderate (0.41≤k≤0.6) interobserver reliability. Improvement potential was low (<10%) for five indicators. Twenty-one indicators, including three outcome indicators, nine process indicators and nine structure indicators, could be used to assess the quality of care delivered in our six study hospitals. CONCLUSION: We developed a face and content valid set of quality indicators for optimal perioperative diabetes care throughout the hospital care pathway, using a rigorous and systematic approach. The results from our practice test show that it is essential to subject indicators to a practice test before applying them for quality improvement purposes. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov: NCT01610674. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
BACKGROUND: In this study, we aim to develop a set of quality indicators for optimal perioperative diabetes care throughout the hospital care pathway and to gain insight into the feasibility of the indicator set in daily clinical practice by assessing the clinimetric properties of the indicators in a practice test. METHODS: A literature-based modified Delphi method was used to develop a set of quality indicators. To assess clinimetric properties of each indicator (measurability, applicability, reliability, improvement potential and case-mix stability), a practice test was performed in six Dutch hospitals using a sample of 389 major surgery patients with diabetes who underwent abdominal, cardiac or large joint orthopaedic surgery. RESULTS: We developed a set of 36 quality indicators for perioperative diabetes care. The practice test showed that one indicator was inapplicable, and nine indicators were unmeasurable. Interobserver reliability was good (0.61≤k≤0.8) for all indicators except for one with moderate (0.41≤k≤0.6) interobserver reliability. Improvement potential was low (<10%) for five indicators. Twenty-one indicators, including three outcome indicators, nine process indicators and nine structure indicators, could be used to assess the quality of care delivered in our six study hospitals. CONCLUSION: We developed a face and content valid set of quality indicators for optimal perioperative diabetes care throughout the hospital care pathway, using a rigorous and systematic approach. The results from our practice test show that it is essential to subject indicators to a practice test before applying them for quality improvement purposes. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov: NCT01610674. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Entities:
Keywords:
Diabetes mellitus; Hospital medicine; Performance measures; Quality measurement; Surgery
Authors: Jaap Ten Oever; Joëll L Jansen; Thomas W van der Vaart; Jeroen A Schouten; Marlies E J L Hulscher; Annelies Verbon Journal: J Antimicrob Chemother Date: 2019-11-01 Impact factor: 5.790
Authors: Miranda W Langendam; Thomas Piggott; Monika Nothacker; Arnav Agarwal; David Armstrong; Tejan Baldeh; Jeffrey Braithwaite; Carolina Castro Martins; Andrea Darzi; Itziar Etxeandia; Ivan Florez; Jan Hoving; Samer G Karam; Thomas Kötter; Joerg J Meerpohl; Reem A Mustafa; Giovanna E U Muti-Schünemann; Philip J van der Wees; Markus Follmann; Holger J Schünemann Journal: BMC Health Serv Res Date: 2020-09-16 Impact factor: 2.655