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Quality Measurement in Neonatal Surgical Disorders: Development of Clinical Indicators
Ernest van Heurn1, Ivo de Blaauw2, Hugo Heij3
1Department of Pediatric Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
Insights
This study developed 24 quality indicators for neonatal surgical care, including 12 process and 12 outcome measures. These indicators will help monitor and improve surgical quality for newborns.
Area of Science:
- Pediatric Surgery
- Healthcare Quality Improvement
- Neonatal Care
Background:
- Surgical care for neonates with congenital disorders requires robust quality assessment.
- Existing quality metrics for neonatal surgery are limited, necessitating development of standardized indicators.
Framework:
- A multidisciplinary expert panel established national guidelines for neonatal surgical care processes.
- Consensus was reached on 6 out of 7 key surgical care processes.
- A total of 24 quality indicators were selected, comprising 12 process and 12 outcome measures.
Implementation:
- A national database was created to collect data on neonatal surgical care.
- Internal (clinical) indicators were developed to ensure data privacy for participating centers.
- A pilot study was conducted to evaluate the feasibility and utility of the quality indicators in clinical practice.
Implications:
- The developed quality indicators provide a framework for monitoring and enhancing the quality of neonatal surgical care.
- Internal indicators facilitate quality assessment without compromising individual physician data.
- This initiative supports continuous improvement in surgical outcomes for neonates.
Objective:
This study aims to develop a set of quality indicators for the measurement of the quality of surgical care for neonates with surgical disorders.
Methods:
An expert panel of the Netherlands Association of Pediatric Surgeons developed internal (clinical) indicators for neonatal surgery. This included the selection of appropriate care processes, a review of the scientific literature, consensus meetings to establish national guidelines, selection of clinical indicators with independent external evaluation, the setup of a national database, and a pilot study in one of the hospitals to evaluate the defined quality indicators in clinical practice.
Results:
Seven neonatal surgical care processes were selected. Clinical guidelines to evaluate the care processes were established in six of seven disorders and were based on consensus agreement, which was reached in 81 to 97% of in total 220 relevant items. The expert panel selected a set of 24 indicators to estimate the quality of neonatal surgical care, of which 12 were outcome indicators and 12 process indicators.
Conclusion:
The development of quality indicators is an important step toward monitoring and, if necessary, improving the quality of neonatal surgical care. Internal or clinical indicators guarantee that the results are only disclosed to the participating center itself and are therefore no threat to individual doctors.
