Perioperative diabetes care: development and validation of quality indicators throughout the entire hospital care pathway.

Abstract:

BACKGROUND:In this study, we aim to develop a set of quality indicators for optimal perioperative diabetes care throughout the hospital care pathway and to gain insight into the feasibility of the indicator set in daily clinical practice by assessing the clinimetric properties of the indicators in a practice test. METHODS:A literature-based modified Delphi method was used to develop a set of quality indicators. To assess clinimetric properties of each indicator (measurability, applicability, reliability, improvement potential and case-mix stability), a practice test was performed in six Dutch hospitals using a sample of 389 major surgery patients with diabetes who underwent abdominal, cardiac or large joint orthopaedic surgery. RESULTS:We developed a set of 36 quality indicators for perioperative diabetes care. The practice test showed that one indicator was inapplicable, and nine indicators were unmeasurable. Interobserver reliability was good (0.61≤k≤0.8) for all indicators except for one with moderate (0.41≤k≤0.6) interobserver reliability. Improvement potential was low (<10%) for five indicators. Twenty-one indicators, including three outcome indicators, nine process indicators and nine structure indicators, could be used to assess the quality of care delivered in our six study hospitals. CONCLUSION:We developed a face and content valid set of quality indicators for optimal perioperative diabetes care throughout the hospital care pathway, using a rigorous and systematic approach. The results from our practice test show that it is essential to subject indicators to a practice test before applying them for quality improvement purposes. TRIAL REGISTRATION NUMBER:ClinicalTrials.gov: NCT01610674.

journal_name

BMJ Qual Saf

journal_title

BMJ quality & safety

authors

Hommel I,van Gurp PJ,Tack CJ,Wollersheim H,Hulscher ME

doi

10.1136/bmjqs-2015-004112

subject

Has Abstract

pub_date

2016-07-01 00:00:00

pages

525-34

issue

7

eissn

2044-5415

issn

2044-5423

pii

bmjqs-2015-004112

journal_volume

25

pub_type

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