Journal
JOURNAL OF PERINATOLOGY
Volume 31, Issue 11, Pages 702-710Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/jp.2011.12
Keywords
infant; newborn; quality of health care; measurement; composite indicator; Delphi method
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Funding
- Eunice Kennedy Shriver National Institute of Child Health and Human Development [K23 HD056298-01, K24 HD053771]
- American Heart Association [0540043N]
- Veterans Administration Center [VA HSRD CoE HFP90-20]
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Objective: To systematically rate measures of care quality for very low birth weight infants for inclusion into Baby-MONITOR, a composite indicator of quality. Study Design: Modified Delphi expert panelist process including electronic surveys and telephone conferences. Panelists considered 28 standard neonatal intensive care unit (NICU) quality measures and rated each on a 9-point scale taking into account pre-defined measure characteristics. In addition, panelists grouped measures into six domains of quality. We selected measures by testing for rater agreement using an accepted method. Result: Of 28 measures considered, 13 had median ratings in the high range (7 to 9). Of these, 9 met the criteria for inclusion in the composite: antenatal steroids (median (interquartile range)) 9(0), timely retinopathy of prematurity exam 9(0), late onset sepsis 9(1), hypothermia on admission 8(1), pneumothorax 8(2), growth velocity 8(2), oxygen at 36 weeks postmenstrual age 7(2), any human milk feeding at discharge 7(2) and in-hospital mortality 7(2). Among the measures selected for the composite, the domains of quality most frequently represented included effectiveness (40%) and safety (30%). Conclusion: A panel of experts selected 9 of 28 routinely reported quality measures for inclusion in a composite indicator. Panelists also set an agenda for future research to close knowledge gaps for quality measures not selected for the Baby-MONITOR. Journal of Perinatology (2011) 31, 702-710; doi:10.1038/jp.2011.12; published online 24 February 2011
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