Development of Primary Palliative Care End-of-Life Quality Measures: A Modified Delphi Process
Title
Development of Primary Palliative Care End-of-Life Quality Measures: A Modified Delphi Process
Creator
Bogetz JF; Johnston EE; Thienprayoon R; Patneaude A; Ananth P; Rosenberg AR; Workgroup Cambia Advisory
Identifier
Publisher
Pediatrics
Date
2022
Subject
Delphi Study; Quality Measures
Description
Children with complex chronic conditions (CCCs) and their families deserve high-quality pediatric palliative care (PPC) throughout their illness trajectory, including at end of life (EOL). Standard EOL quality measures (QM) have only recently been proposed, require surveys and/or manual chart review, and focus on children with cancer. Therefore, we aimed to develop expert-endorsed, hospital-based, primary PPC quality measures for EOL care for all children with CCCs that could be automatically abstracted from the electronic health record (EHR).We followed a modified Delphi approach for expert opinion gathering, including: (1) a comprehensive literature review of existing adult and pediatric measures (\textgreater200 measures); (2) formation of a multidisciplinary expert panel (n = 9); (3) development of a list of candidate measures (20 measures); (4) national survey to assess each QM’s importance and abstraction feasibility and propose new measures (respondents = 95); and (5) final expert panel endorsement.Seventeen EHR-abstractable QM were endorsed in 5 domains: (1) health care utilization: 4 measures (eg, \textless2 emergency department visits in the last 30 days of life); (2) interprofessional services: 4 measures (eg, PPC in the last 30 days of life); (3) medical intensity: 5 measures (eg, death outside the ICU); (4) symptom management: 2 measures (eg, documented pain score within 24 hours of admission); and (5) communication: 2 measures (eg, code status documentation).This study developed a list of EHR-abstractable, hospital-based primary PPC EOL QM, providing a foundation for quality improvement initiatives and further measure development in the future.
Rights
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Citation List Month
January List 2023
URL Address
Collection
Citation
Bogetz JF; Johnston EE; Thienprayoon R; Patneaude A; Ananth P; Rosenberg AR; Workgroup Cambia Advisory, “Development of Primary Palliative Care End-of-Life Quality Measures: A Modified Delphi Process,” Pediatric Palliative Care Library, accessed February 8, 2025, https://pedpalascnetlibrary.omeka.net/items/show/18565.