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Developing Resident-Sensitive Quality Measures: Engaging Stakeholders to Inform Next Steps.

Daniel J Schumacher1, Abigail Martini1, Eric Holmboe2

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Developing resident-sensitive quality measures (RSQMs) is crucial for healthcare quality. This study engaged residents and supervisors to identify key areas like medication dosing and documentation for future pediatric emergency department quality improvement.

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Area of Science:

  • Medical Education
  • Healthcare Quality Improvement
  • Pediatric Emergency Medicine

Background:

  • There is a recognized need for quality measures tailored to the work performed by medical residents.
  • Existing quality measures often do not adequately address the specific contributions and learning experiences of residents.
  • Resident-sensitive quality measures (RSQMs) offer a potential solution to bridge this gap in healthcare quality assessment.

Purpose of the Study:

  • To engage resident and supervisor stakeholders in the development of novel resident-sensitive quality measures (RSQMs).
  • To identify key areas and settings for the creation of future RSQMs within pediatric emergency care.
  • To explore the perspectives of both residents and supervisors in the quality improvement process.

Main Methods:

  • Utilized nominal group techniques (NGTs) with residents and supervisors to generate RSQMs for specific illnesses and general pediatric emergency care.
  • Employed Delphi processes to prioritize the generated RSQMs.
  • Conducted focus groups to compare measures, explore differences, and identify future development settings.

Main Results:

  • Residents and supervisors identified key areas for RSQMs, including medication dosing, documentation, and discharge information, across asthma, bronchiolitis, and closed head injury.
  • Focus groups indicated hospital medicine and general pediatrics as priority settings for future RSQM development.
  • Both residents and supervisors offered unique and overlapping insights crucial for RSQM creation.

Conclusions:

  • This study lays the groundwork for developing future resident-sensitive quality measures by identifying relevant stakeholders, settings, and measure categories.
  • The findings highlight the importance of collaborative development involving both residents and supervisors in healthcare quality initiatives.
  • Further exploration of contextual variables is needed for effective implementation of RSQMs in diverse healthcare settings.