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Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi

Anita V Arias1,2, Marcela Garza2, Srinivas Murthy3

  • 1Division of Pediatric Critical Care, University of Tennessee Health Science Center, Memphis, TN, USA.

Cancer Medicine
|August 11, 2020
PubMed

Insights

Hospitalized pediatric hematology-oncology patients need quality indicators for critical care. The PROACTIVE tool identifies key indicators like designated PICU areas and available pediatric intensivists to improve care in resource-limited settings.

Area of Science:

  • Pediatric Critical Care
  • Oncology
  • Healthcare Quality Improvement

Background:

  • Hospitalized pediatric hematology-oncology (PHO) patients face high risks of critical illness, particularly in resource-limited environments.
  • Existing quality indicators for PHO critical care are lacking, hindering institutional improvement efforts.

Purpose of the Study:

  • To identify and develop quality indicators for assessing the capacity and quality of pediatric critical care services for PHO patients.
  • To create the PROACTIVE (PediatRic Oncology cApaCity assessment Tool for IntensiVe carE) tool.

Main Methods:

  • A literature review identified potential indicators across structure, performance, and outcomes.
  • An international focus group and a modified Delphi process involving 36 experts refined these indicators.
  • Indicators were ranked by relevance and actionability through expert surveys.

Main Results:

  • The PROACTIVE tool comprises 119 indicators across eight domains and 22 subdomains.
  • High median importance and expert agreement were achieved for the indicators.
  • Top indicators include: designated PICU area, availability of pediatric intensivists, PHO physician involvement, trained nursing staff, and timely PICU transfer.

Conclusions:

  • PROACTIVE is a consensus-based tool designed to evaluate pediatric onco-critical care quality, especially in resource-limited settings.
  • Future work will focus on validating PROACTIVE by linking indicators to clinical outcomes and implementing it to address service gaps.
Abstract

Keywords:
clinical cancer researchpediatric cancertranslational research

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