Development of Primary Palliative Care End-of-Life Quality Measures: A Modified Delphi Process
Children with complex chronic conditions (CCCs) and their families deserve high-quality pediatric palliative care (PPC) throughout their illness trajectory, including at end of life (EOL). Standard EOL quality measures (QM) have only recently been proposed, require surveys and/or manual chart review...
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| Veröffentlicht in: | Pediatrics (Evanston) 2022-12, Vol.150 (6), p.1 |
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| creator | Bogetz, Jori F Johnston, Emily E Thienprayoon, Rachel Patneaude, Arika Ananth, Prasanna Rosenberg, Abby R |
| description | Children with complex chronic conditions (CCCs) and their families deserve high-quality pediatric palliative care (PPC) throughout their illness trajectory, including at end of life (EOL). Standard EOL quality measures (QM) have only recently been proposed, require surveys and/or manual chart review, and focus on children with cancer. Therefore, we aimed to develop expert-endorsed, hospital-based, primary PPC quality measures for EOL care for all children with CCCs that could be automatically abstracted from the electronic health record (EHR).
We followed a modified Delphi approach for expert opinion gathering, including: (1) a comprehensive literature review of existing adult and pediatric measures (>200 measures); (2) formation of a multidisciplinary expert panel (n = 9); (3) development of a list of candidate measures (20 measures); (4) national survey to assess each QM's importance and abstraction feasibility and propose new measures (respondents = 95); and (5) final expert panel endorsement.
Seventeen EHR-abstractable QM were endorsed in 5 domains: (1) health care utilization: 4 measures (eg, |
| doi_str_mv | 10.1542/peds.2022-058241 |
| format | Article |
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We followed a modified Delphi approach for expert opinion gathering, including: (1) a comprehensive literature review of existing adult and pediatric measures (>200 measures); (2) formation of a multidisciplinary expert panel (n = 9); (3) development of a list of candidate measures (20 measures); (4) national survey to assess each QM's importance and abstraction feasibility and propose new measures (respondents = 95); and (5) final expert panel endorsement.
Seventeen EHR-abstractable QM were endorsed in 5 domains: (1) health care utilization: 4 measures (eg, <2 emergency department visits in the last 30 days of life); (2) interprofessional services: 4 measures (eg, PPC in the last 30 days of life); (3) medical intensity: 5 measures (eg, death outside the ICU); (4) symptom management: 2 measures (eg, documented pain score within 24 hours of admission); and (5) communication: 2 measures (eg, code status documentation).
This study developed a list of EHR-abstractable, hospital-based primary PPC EOL QM, providing a foundation for quality improvement initiatives and further measure development in the future.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2022-058241</identifier><identifier>PMID: 36437228</identifier><language>eng</language><publisher>United States: American Academy of Pediatrics</publisher><subject>Adult ; Child ; Children ; Chronic illnesses ; Electronic health records ; Electronic medical records ; Emergency medical care ; Endorsements ; Hospitals ; Humans ; Literature reviews ; Palliation ; Palliative Care ; Pediatrics ; Quality control ; Quality of Health Care ; Quality of Life ; Surveys ; Symptom management ; Terminal Care</subject><ispartof>Pediatrics (Evanston), 2022-12, Vol.150 (6), p.1</ispartof><rights>Copyright © 2022 by the American Academy of Pediatrics.</rights><rights>Copyright American Academy of Pediatrics Dec 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c369t-750d8351fcdc348db6bb7cbe7296734c21152bfbccd735441fbf5b2f92e3b0753</citedby><cites>FETCH-LOGICAL-c369t-750d8351fcdc348db6bb7cbe7296734c21152bfbccd735441fbf5b2f92e3b0753</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36437228$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bogetz, Jori F</creatorcontrib><creatorcontrib>Johnston, Emily E</creatorcontrib><creatorcontrib>Thienprayoon, Rachel</creatorcontrib><creatorcontrib>Patneaude, Arika</creatorcontrib><creatorcontrib>Ananth, Prasanna</creatorcontrib><creatorcontrib>Rosenberg, Abby R</creatorcontrib><creatorcontrib>Cambia Advisory Workgroup</creatorcontrib><title>Development of Primary Palliative Care End-of-Life Quality Measures: A Modified Delphi Process</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>Children with complex chronic conditions (CCCs) and their families deserve high-quality pediatric palliative care (PPC) throughout their illness trajectory, including at end of life (EOL). Standard EOL quality measures (QM) have only recently been proposed, require surveys and/or manual chart review, and focus on children with cancer. Therefore, we aimed to develop expert-endorsed, hospital-based, primary PPC quality measures for EOL care for all children with CCCs that could be automatically abstracted from the electronic health record (EHR).
We followed a modified Delphi approach for expert opinion gathering, including: (1) a comprehensive literature review of existing adult and pediatric measures (>200 measures); (2) formation of a multidisciplinary expert panel (n = 9); (3) development of a list of candidate measures (20 measures); (4) national survey to assess each QM's importance and abstraction feasibility and propose new measures (respondents = 95); and (5) final expert panel endorsement.
Seventeen EHR-abstractable QM were endorsed in 5 domains: (1) health care utilization: 4 measures (eg, <2 emergency department visits in the last 30 days of life); (2) interprofessional services: 4 measures (eg, PPC in the last 30 days of life); (3) medical intensity: 5 measures (eg, death outside the ICU); (4) symptom management: 2 measures (eg, documented pain score within 24 hours of admission); and (5) communication: 2 measures (eg, code status documentation).
This study developed a list of EHR-abstractable, hospital-based primary PPC EOL QM, providing a foundation for quality improvement initiatives and further measure development in the future.</description><subject>Adult</subject><subject>Child</subject><subject>Children</subject><subject>Chronic illnesses</subject><subject>Electronic health records</subject><subject>Electronic medical records</subject><subject>Emergency medical care</subject><subject>Endorsements</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Literature reviews</subject><subject>Palliation</subject><subject>Palliative Care</subject><subject>Pediatrics</subject><subject>Quality control</subject><subject>Quality of Health Care</subject><subject>Quality of Life</subject><subject>Surveys</subject><subject>Symptom management</subject><subject>Terminal Care</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkEtLxDAURoMoOo7uXUnAjZvqzatp3cmMLxhRQbeWJrnBSGdSm1bw3ztl1IWruznf4XIIOWJwxpTk5y26dMaB8wxUwSXbIhMGZZFJrtU2mQAIlkkAtUf2U3oHAKk03yV7IpdCc15MyOscP7GJ7RJXPY2ePnZhWXdf9LFumlD34RPprO6QXq1cFn22CB7p01A3of-i91inocN0QS_pfXTBB3R0jk37FtaeaDGlA7Lj6ybh4c-dkpfrq-fZbbZ4uLmbXS4yK_Kyz7QCVwjFvHVWyMKZ3BhtDWpe5lpIyxlT3HhjrdNCScm88cpwX3IUBrQSU3K68bZd_Bgw9dUyJItNU68wDqniWkIJpVgXmZKTf-h7HLrV-ruRymVRSjYKYUPZLqbUoa_aTZmKQTW2r8b21di-2rRfT45_xINZovsb_MYW37eSfto</recordid><startdate>20221201</startdate><enddate>20221201</enddate><creator>Bogetz, Jori F</creator><creator>Johnston, Emily E</creator><creator>Thienprayoon, Rachel</creator><creator>Patneaude, Arika</creator><creator>Ananth, Prasanna</creator><creator>Rosenberg, Abby R</creator><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20221201</creationdate><title>Development of Primary Palliative Care End-of-Life Quality Measures: A Modified Delphi Process</title><author>Bogetz, Jori F ; Johnston, Emily E ; Thienprayoon, Rachel ; Patneaude, Arika ; Ananth, Prasanna ; Rosenberg, Abby R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c369t-750d8351fcdc348db6bb7cbe7296734c21152bfbccd735441fbf5b2f92e3b0753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Child</topic><topic>Children</topic><topic>Chronic illnesses</topic><topic>Electronic health records</topic><topic>Electronic medical records</topic><topic>Emergency medical care</topic><topic>Endorsements</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Literature reviews</topic><topic>Palliation</topic><topic>Palliative Care</topic><topic>Pediatrics</topic><topic>Quality control</topic><topic>Quality of Health Care</topic><topic>Quality of Life</topic><topic>Surveys</topic><topic>Symptom management</topic><topic>Terminal Care</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bogetz, Jori F</creatorcontrib><creatorcontrib>Johnston, Emily E</creatorcontrib><creatorcontrib>Thienprayoon, Rachel</creatorcontrib><creatorcontrib>Patneaude, Arika</creatorcontrib><creatorcontrib>Ananth, Prasanna</creatorcontrib><creatorcontrib>Rosenberg, Abby R</creatorcontrib><creatorcontrib>Cambia Advisory Workgroup</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bogetz, Jori F</au><au>Johnston, Emily E</au><au>Thienprayoon, Rachel</au><au>Patneaude, Arika</au><au>Ananth, Prasanna</au><au>Rosenberg, Abby R</au><aucorp>Cambia Advisory Workgroup</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development of Primary Palliative Care End-of-Life Quality Measures: A Modified Delphi Process</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2022-12-01</date><risdate>2022</risdate><volume>150</volume><issue>6</issue><spage>1</spage><pages>1-</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><abstract>Children with complex chronic conditions (CCCs) and their families deserve high-quality pediatric palliative care (PPC) throughout their illness trajectory, including at end of life (EOL). Standard EOL quality measures (QM) have only recently been proposed, require surveys and/or manual chart review, and focus on children with cancer. Therefore, we aimed to develop expert-endorsed, hospital-based, primary PPC quality measures for EOL care for all children with CCCs that could be automatically abstracted from the electronic health record (EHR).
We followed a modified Delphi approach for expert opinion gathering, including: (1) a comprehensive literature review of existing adult and pediatric measures (>200 measures); (2) formation of a multidisciplinary expert panel (n = 9); (3) development of a list of candidate measures (20 measures); (4) national survey to assess each QM's importance and abstraction feasibility and propose new measures (respondents = 95); and (5) final expert panel endorsement.
Seventeen EHR-abstractable QM were endorsed in 5 domains: (1) health care utilization: 4 measures (eg, <2 emergency department visits in the last 30 days of life); (2) interprofessional services: 4 measures (eg, PPC in the last 30 days of life); (3) medical intensity: 5 measures (eg, death outside the ICU); (4) symptom management: 2 measures (eg, documented pain score within 24 hours of admission); and (5) communication: 2 measures (eg, code status documentation).
This study developed a list of EHR-abstractable, hospital-based primary PPC EOL QM, providing a foundation for quality improvement initiatives and further measure development in the future.</abstract><cop>United States</cop><pub>American Academy of Pediatrics</pub><pmid>36437228</pmid><doi>10.1542/peds.2022-058241</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Child Children Chronic illnesses Electronic health records Electronic medical records Emergency medical care Endorsements Hospitals Humans Literature reviews Palliation Palliative Care Pediatrics Quality control Quality of Health Care Quality of Life Surveys Symptom management Terminal Care |
| title | Development of Primary Palliative Care End-of-Life Quality Measures: A Modified Delphi Process |
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