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Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensus
BACKGROUND: Hospitalized pediatric hematology‐oncology (PHO) patients are at high risk for critical illness, especially in resource‐limited settings. Unfortunately, there are no established quality indicators to guide institutional improvement for these patients. The objective of this study was to i...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7541142/ https://www.ncbi.nlm.nih.gov/pubmed/32777172 http://dx.doi.org/10.1002/cam4.3351 |
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author | Arias, Anita V. Garza, Marcela Murthy, Srinivas Cardenas, Adolfo Diaz, Franco Montalvo, Erika Nielsen, Katie R. Kortz, Teresa Sharara‐Chami, Rana Friedrich, Paola McArthur, Jennifer Agulnik, Asya |
author_facet | Arias, Anita V. Garza, Marcela Murthy, Srinivas Cardenas, Adolfo Diaz, Franco Montalvo, Erika Nielsen, Katie R. Kortz, Teresa Sharara‐Chami, Rana Friedrich, Paola McArthur, Jennifer Agulnik, Asya |
author_sort | Arias, Anita V. |
collection | PubMed |
description | BACKGROUND: Hospitalized pediatric hematology‐oncology (PHO) patients are at high risk for critical illness, especially in resource‐limited settings. Unfortunately, there are no established quality indicators to guide institutional improvement for these patients. The objective of this study was to identify quality indicators to include in PROACTIVE (PediatRic Oncology cApaCity assessment Tool for IntensiVe carE), an assessment tool to evaluate the capacity and quality of pediatric critical care services offered to PHO patients. METHODS: A comprehensive literature review identified relevant indicators in the areas of structure, performance, and outcomes. An international focus group sorted potential indicators using the framework of domains and subdomains. A modified, three‐round Delphi was conducted among 36 international experts with diverse experience in PHO and critical care in high‐resource and resource‐limited settings. Quality indicators were ranked on relevance and actionability via electronically distributed surveys. RESULTS: PROACTIVE contains 119 indicators among eight domains and 22 subdomains, with high‐median importance (≥7) in both relevance and actionability, and ≥80% evaluator agreement. The top five indicators were: (a) A designated PICU area; (b) Availability of a pediatric intensivist; (c) A PHO physician as part of the primary team caring for critically ill PHO patients; (d) Trained nursing staff in pediatric critical care; and (e) Timely PICU transfer of hospitalized PHO patients requiring escalation of care. CONCLUSIONS: PROACTIVE is a consensus‐derived tool to assess the capacity and quality of pediatric onco‐critical care in resource‐limited settings. Future endeavors include validation of PROACTIVE by correlating the proposed indicators to clinical outcomes and its implementation to identify service delivery gaps amenable to improvement. |
format | Online Article Text |
id | pubmed-7541142 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-75411422020-10-09 Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensus Arias, Anita V. Garza, Marcela Murthy, Srinivas Cardenas, Adolfo Diaz, Franco Montalvo, Erika Nielsen, Katie R. Kortz, Teresa Sharara‐Chami, Rana Friedrich, Paola McArthur, Jennifer Agulnik, Asya Cancer Med Clinical Cancer Research BACKGROUND: Hospitalized pediatric hematology‐oncology (PHO) patients are at high risk for critical illness, especially in resource‐limited settings. Unfortunately, there are no established quality indicators to guide institutional improvement for these patients. The objective of this study was to identify quality indicators to include in PROACTIVE (PediatRic Oncology cApaCity assessment Tool for IntensiVe carE), an assessment tool to evaluate the capacity and quality of pediatric critical care services offered to PHO patients. METHODS: A comprehensive literature review identified relevant indicators in the areas of structure, performance, and outcomes. An international focus group sorted potential indicators using the framework of domains and subdomains. A modified, three‐round Delphi was conducted among 36 international experts with diverse experience in PHO and critical care in high‐resource and resource‐limited settings. Quality indicators were ranked on relevance and actionability via electronically distributed surveys. RESULTS: PROACTIVE contains 119 indicators among eight domains and 22 subdomains, with high‐median importance (≥7) in both relevance and actionability, and ≥80% evaluator agreement. The top five indicators were: (a) A designated PICU area; (b) Availability of a pediatric intensivist; (c) A PHO physician as part of the primary team caring for critically ill PHO patients; (d) Trained nursing staff in pediatric critical care; and (e) Timely PICU transfer of hospitalized PHO patients requiring escalation of care. CONCLUSIONS: PROACTIVE is a consensus‐derived tool to assess the capacity and quality of pediatric onco‐critical care in resource‐limited settings. Future endeavors include validation of PROACTIVE by correlating the proposed indicators to clinical outcomes and its implementation to identify service delivery gaps amenable to improvement. John Wiley and Sons Inc. 2020-08-10 /pmc/articles/PMC7541142/ /pubmed/32777172 http://dx.doi.org/10.1002/cam4.3351 Text en © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Cancer Research Arias, Anita V. Garza, Marcela Murthy, Srinivas Cardenas, Adolfo Diaz, Franco Montalvo, Erika Nielsen, Katie R. Kortz, Teresa Sharara‐Chami, Rana Friedrich, Paola McArthur, Jennifer Agulnik, Asya Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensus |
title | Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensus |
title_full | Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensus |
title_fullStr | Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensus |
title_full_unstemmed | Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensus |
title_short | Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensus |
title_sort | quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: a modified delphi consensus |
topic | Clinical Cancer Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7541142/ https://www.ncbi.nlm.nih.gov/pubmed/32777172 http://dx.doi.org/10.1002/cam4.3351 |
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