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Hospital-to-home transitions for children with medical complexity: part 2-a core outcome set
Heleen N Haspels1,2, Annemieke A de Lange3, Mattijs W Alsem3,4
1Department of Pediatric Intensive Care Unit, Amsterdam Reproduction and Development, Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, The Netherlands.
Insights
A Core Outcome Set (COS) was developed for Children with Medical Complexity (CMC) transitioning from hospital to home. This set includes disease management, child quality of life, family impact, and parent self-efficacy, improving research consistency.
Area of Science:
- Pediatrics
- Health Services Research
- Patient-Reported Outcomes
Background:
- Hospital-to-home transitions for Children with Medical Complexity (CMC) present significant challenges.
- High-quality intervention trials require appropriate outcome measures for effective transitional care.
- Core Outcome Sets (COS) enhance research consistency and improve outcomes for children and families.
Purpose of the Study:
- To identify a consensus-based Core Outcome Set (COS) for intervention research focused on hospital-to-home transitions for CMC.
- To incorporate the perspectives of both healthcare professionals and parents of CMC in defining essential outcomes.
Main Methods:
- A two-phase approach was employed: a three-round Delphi study with healthcare professionals and focus groups with parents of CMC.
- Healthcare professionals rated 24 pre-identified outcomes and suggested 12 new ones.
- Parent focus groups validated Delphi study findings and identified additional core outcomes.
Main Results:
- The Delphi study identified three core outcomes: disease management, child's quality of life, and impact on the life of families.
- Parent focus groups added 'self-efficacy of parents' as a fourth core outcome.
- The developed COS is evidence-informed and based on consensus from diverse stakeholders.
Conclusions:
- An evidence-informed Core Outcome Set (COS) has been established for CMC hospital-to-home transition research.
- This COS can standardize outcome reporting in future intervention studies.
- The next step involves selecting appropriate measurement instruments for each outcome in the COS.
Abstract:
Appropriate outcome measures as part of high-quality intervention trials are critical to advancing hospital-to-home transitions for Children with Medical Complexity (CMC). Our aim was to conduct a Delphi study and focus groups to identify a Core Outcome Set (COS) that healthcare professionals and parents consider essential outcomes for future intervention research. The development process consisted of two phases: (1) a three-round Delphi study in which different professionals rated outcomes, previously described in a systematic review, for inclusion in the COS and (2) focus groups with parents of CMC to validate the results of the Delphi study. Forty-five professionals participated in the Delphi study. The response rates were 55%, 57%, and 58% in the three rounds, respectively. In addition to the 24 outcomes from the literature, the participants suggested 12 additional outcomes. The Delphi rounds resulted in the following core outcomes: (1) disease management, (2) child's quality of life, and (3) impact on the life of families. Two focus groups with seven parents highlighted another core outcome: (4) self-efficacy of parents. Conclusion: An evidence-informed COS has been developed based on consensus among healthcare professionals and parents. These core outcomes could facilitate standard reporting in future CMC hospital to home transition research. This study facilitated the next step of COS development: selecting the appropriate measurement instruments for every outcome. What is Known: • Hospital-to-home transition for Children with Medical Complexity is a challenging process. • The use of core outcome sets could improve the quality and consistency of research reporting, ultimately leading to better outcomes for children and families. What is New: • The Core Outcome Set for transitional care for Children with Medical Complexity includes four outcomes: disease management, children's quality of life, impact on the life of families, and self-efficacy of parents.
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