Development of prehospital care quality indicators for the Australian setting: a modified RAND/UCLA appropriateness method.
Emergency Medicine Journal · 2021-07-21 · Guideline / consensus
Abstract
BACKGROUND: Globally, the measurement of quality is an important process that supports the provision of high-quality and safe healthcare services. The requirement for valid quality measurement to gauge improvements and monitor performance is echoed in the Australian prehospital care setting. The aim of this study was to use an evidence-informed expert consensus process to identify valid quality indicators (QIs) for Australian prehospital care provided by ambulance services. METHODS: A modified RAND/UCLA appropriateness method was conducted with a panel of Australian prehospital care experts from February to May 2019. The proposed QIs stemmed from a scoping review and were systematically prepared within a clinical and non-clinical classification system, and a structure/process/outcome and access/safety/effectiveness taxonomy. Rapid reviews were performed for each QI to produce evidence summaries for consideration by the panellists. QIs were deemed valid if the median score by the panel was 7-9 without disagreement. RESULTS: Of 117 QIs, the expert panel rated 84 (72%) as valid. This included 26 organisational/system QIs across 7 subdomains and 58 clinical QIs within 10 subdomains.Most QIs were process indicators (n=62; 74%) while QIs describing structural elements and desired outcomes were less common (n=13; 15% and n=9; 11%, respectively). Non-exclusively, 18 (21%) QIs addressed access to healthcare, 21 (25%) described safety aspects and 64 (76%) specified elements contributing to effective services and care. QIs on general time intervals, such as response time, were not considered valid by the panel. CONCLUSION: This study demonstrates that with consideration of best available evidence a substantial proportion of QIs scoped and synthesised from the international literature are valid for use in the Australian prehospital care context.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Research methods & trial conduct
Related articles
- Implementation of health care quality indicators for out-of-hospital emergencies: a systematic review. (Emergencias, 2019)
- Quality Indicators for Evaluating Prehospital Emergency Care: A Scoping Review. (Prehosp Disaster Med, 2018)
- Multi-method versus single method appraisal of clinical quality indicators for the emergency medical services. (Int J Qual Health Care, 2021)
- Development and testing of Australian prehospital care quality indicators: study protocol. (BMJ Open, 2020)
- Development of a Binary End-of-Event Outcome Indicator for the NEMSIS Public Release Research Dataset. (Prehosp Emerg Care, 2021)
- Global emergency care clinical practice guidelines: A landscape analysis. (Afr J Emerg Med, 2018)