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Developing Resident-Sensitive Quality Measures: A Model From Pediatric Emergency Medicine
Daniel J Schumacher1, Eric S Holmboe, Cees van der Vleuten
1D.J. Schumacher is assistant professor, Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; ORCID: https://orcid.org/0000-0001-5507-8452. E.S. Holmboe is senior vice president for milestones development and evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois. C. van der Vleuten is professor of education, Department of Educational Development and Research, Faculty of Health, Medicine, and Life Sciences, and scientific director, School of Health Professions Education, Maastricht University, Maastricht, The Netherlands. J.O. Busari is consultant pediatrician and associate professor of medical education, Maastricht University, Maastricht, The Netherlands. C. Carraccio is vice president of competency-based assessment, American Board of Pediatrics, Chapel Hill, North Carolina.
Researchers developed resident-sensitive quality measures (RSQMs) for pediatric emergency departments to improve care quality during resident training. This study outlines a method for creating and validating these crucial measures.
Area of Science:
- Medical Education
- Quality Improvement
- Pediatric Emergency Medicine
Background:
- Quality measures are essential for assessing and improving resident performance.
- Existing quality measures may not adequately reflect the unique contributions and learning experiences of residents.
- There is a need for resident-sensitive quality measures (RSQMs) specifically for the pediatric emergency department (PED) setting.
Purpose of the Study:
- To identify and develop resident-sensitive quality measures (RSQMs) for the pediatric emergency department (PED).
- To address the gap in quality measures applicable to resident training and performance.
- To create measures focused on common acute illnesses encountered in the PED.
Main Methods:
- A systematic review of the National Quality Measures Clearinghouse (NQMC) was conducted to identify potentially resident-sensitive measures.
- A nominal group technique (NGT) and Delphi process were employed to develop new measures for acute asthma exacerbation, bronchiolitis, and closed head injury (CHI).
- Participants from Cincinnati Children's Hospital Medical Center rated the importance and resident-appropriateness of developed measures.
Main Results:
- The NQMC review identified 28 of 183 measures as potentially resident-sensitive.
- The NGT and Delphi process generated a substantial number of potential measures for asthma (67), bronchiolitis (46), and CHI (48).
- After two rounds of the Delphi process, 18 asthma, 21 bronchiolitis, and 21 CHI measures met inclusion criteria, with further categorization in round three.
Conclusions:
- The study presents a template for identifying and developing RSQMs to enhance high-quality care during and after resident training.
- Further research should focus on implementing these locally developed measures and gathering validity evidence.
- The developed RSQMs have the potential to promote high-quality care delivery within the PED setting.
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