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Establishing gold standards for System-Level Measures: a modified Delphi consensus process
Fiona Doolan-Noble1, Stuart Barson2, M Lyndon3
1Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Objective:
To establish aspirational 'gold standards' for a suite of System-Level Measures (SLMs) being used by Counties Manukau Health (CM Health), a New Zealand (NZ) District Health Board.
Design:
This study employed a multi-stage, multi-method modified Delphi consensus process.
Setting:
The Delphi consensus process involved virtual (email) communication between participants (Round 1) and a structured face-to-face meeting (Round 2) held in Auckland, NZ.
Participants:
Participants comprised of health professionals, managers, academics and quality improvement experts with an interest in the use of SLMs.
Interventions:
Participants in the first round received a letter requesting their participation in an anonymous Delphi. The second round involved national and international health system experts taking part in a structured, facilitated face-to-face meeting. Participants reviewed 15 SLMs in total. The SLMs all related to the three domains of the Triple Aim: Population Health, e.g. life expectancy at birth; Patient Experience of Care, e.g. rate of adverse events; and Cost and Productivity, e.g. healthcare expenditure per capita.
Main Outcome Measures:
For a proposed gold standard to be agreed and established for each SLM.
Results:
Twelve participants took part in Round 1, with 19 participating in Round 2. The process established agreement on a gold standard for each of the 15 reviewed SLMs.
Conclusion:
We demonstrated that the Delphi consensus process can be used to establish gold standards for a suite of SLMs used by a NZ Health Board (CM Health).
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