Establishing a paediatric critical care core quality measure set using a multistakeholder, consensus-driven process

Area of Science:

• Healthcare quality improvement
• Paediatric critical care research
• Health services research

Background:

• Monitoring healthcare quality in paediatric critical care is complex due to varied measures and data collection challenges.
• Establishing consistent quality metrics is vital for improving patient outcomes and care standards.

Purpose of the Study:

• To develop a core set of quality measures for paediatric critical care.
• To ensure measures are meaningful to both consumers (patients/families) and clinicians.
• To promote aligned use and collection of quality measures across the field.

Main Methods:

• A multi-stakeholder Delphi study combined with a consumer prioritisation survey.
• Involved Australian and New Zealand paediatric critical care survivors, families, clinicians, and policymakers.
• Triangulation of survey data preceded a consensus meeting to finalize the measure set.

Main Results:

• Consumers prioritized nurse-patient ratios, visible patient goals, and long-term follow-up.
• Clinicians agreed on a 51-item core measure set, prioritizing nurse-patient ratios, staff turnover, and long-term follow-up.
• Feasibility was rated low due to data collection burden and lack of standardized definitions.

Conclusions:

• A 51-item core measurement set for paediatric critical care has been defined, reflecting clinician and consumer priorities.
• Implementation and evaluation of this set are recommended for quality programs.
• Future work should address measure feasibility and consider retiring redundant measures.