Tuesday, September 24, 2013

Establishing Quality Indicators for How We Manage Acute Pediatric Conditions: It Can Be Done!

Value-based health-care (which is rapidly becoming the driver for health-care reform) is dependent on improving quality while decreasing health-care costs.  Yet while a number of quality measures and indicators have been established to monitor for quality improvement, far fewer exist in the pediatric realm—at least until this week when Stang et al. (doi: 10.1542/peds.2013-0854), using a systematic process, have developed a set of evidence-based quality indicators that may be extremely helpful in emergency departments striving for high reliability in how they diagnose and treat children with acute pediatric conditions.  The authors used a series of questionnaires and in turn an expert panel to identify measures and the feasibility and reliability of collecting those measures.  62 measures are identified, most focused on ED processes, although there are also some that deal with outcomes with at least a third based on moderate- to high-quality evidence.

The next step is to implement these measures and make sure they truly are valid, feasible, and reliable, but to do that, it is important that you first read this article to get a better sense of what the authors have suggested and then discuss these measures with your colleagues who staff your emergency department to see if they want to use them going forward.  The authors have done some great work establishing the groundwork for some quality indicators that have been long sought-after and are now being suggested.

We welcome your comments on these indicators either through our Facebook page or an e-letter—and hope you’ll tell us whether these make sense or even if you are already using some (or all) of them.