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Prioritizing areas for quality marker development in children in UK general practice: extending the use of the
Peter J Gill1, Paul Hewitson, Ed Peile
1Department of Primary Care Health Sciences, University of Oxford, 2nd Floor, 23--38 Hythe Bridge Street, Oxford OX1 2ET, UK. peter.gill@phc.ox.ac.uk
Insights
UK General Practitioners (GPs) identified key areas for improving children's primary care quality. Using the nominal group technique (NGT), they prioritized essential clinical domains for quality marker development.
Area of Science:
- Paediatric Primary Care Quality Improvement
- Healthcare Professional Consensus Building
- Clinical Quality Measurement
Background:
- Lack of standardized methods to assess the quality of paediatric primary care.
- Absence of professional agreement within UK general practice on essential quality markers for child healthcare.
Purpose of the Study:
- To establish priority clinical areas for developing quality markers in paediatric primary care.
- To identify challenges inherent in achieving professional consensus on these markers.
Main Methods:
- Convened an expert panel of General Practitioners (GPs) with a focus on child health.
- Employed the nominal group technique (NGT), a structured facilitation method, to build consensus.
Main Results:
- Identified eight key areas: early recognition of serious illness, safeguarding, health promotion, mental health, evidence-based management, child/carer friendliness, and prescribing.
- Encountered challenges in balancing broad clinical scope with specific focus, managing uncertainty, and preventing 'everything-must-go' tendencies.
Conclusions:
- First consensus study among UK GPs to define priority areas for paediatric primary care quality marker development.
- Nominal group technique effectively highlighted frontline professionals' priorities and illuminated consensus-building challenges in a complex field.
Background:
There is a deficiency in the ability to measure the quality of care of children in primary care and there is no professional consensus in UK general practice regarding which quality markers should be used.
Objectives:
To prioritize clinical areas on which to focus quality marker development in paediatric primary care and to describe the challenges in generating professional consensus.
Methods:
We convened an expert panel of GPs with a special interest in child health and using the nominal group technique (NGT), a well-established structured, multistep facilitated group meeting technique, we generated consensus around the key clinical areas to focus quality marker development.
Results:
Twelve GPs participated in the expert panel. The eight items agreed by panellists as most important were early recognition of serious illness, whole practice involvement in safeguarding, health promotion, mental health, evidence-based management of common conditions, child and carer friendliness and safe and cost-effective prescribing. Panel members struggled to balance the broad clinical areas while attempting to focus on specific areas that are important. The main challenges included managing panel uncertainty, effective organization, presentation of items for review and group inclination to 'include everything'.
Conclusions:
This is the first consensus study of UK GPs to identify key areas to target quality marker development in children. By using the NGT, we have highlighted front-line health care professionals' priorities to improve the quality of care of children and identified the benefits and challenges of developing consensus in a broad topic area.
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