Development of Nurse-Sensitive, Emergency Department-Specific Quality Indicators Using a Modified Delphi Technique

Area of Science:

• Emergency Medicine
• Nursing Quality Improvement
• Healthcare Management

Background:

• No established nursing-sensitive quality indicators specifically for the emergency department (ED) setting exist.
• Existing quality metrics may not be specific to the unique challenges of emergency care.

Purpose of the Study:

• To identify nursing-sensitive, ED-specific quality indicators.
• To address the gap in quality measurement within the emergency care environment.
• To develop and test indicators across different patient populations and phases of the ED visit.

Main Methods:

• A modified Delphi technique was employed to achieve consensus among experts.
• Quality indicators were grouped into thematic categories for analysis.

Main Results:

• Twenty-one quality indicators were identified across four thematic groups: triage (6), special populations (4), transitions of care (4), and medical/surgical (7).
• Triage indicators received the highest ranking for importance.

Conclusions:

• Many initially proposed metrics lacked ED specificity or were influenced by the emergency care environment.
• Alternative methodologies are recommended for identifying critical areas for quality measurement in EDs.