Abstract:
OBJECTIVE:To assess quality of care for children presenting with acute abdominal pain using validated indicators. DESIGN:Audit of care quality for acute abdominal pain according to 21 care quality indicators developed and validated in four stages. SETTING AND PARTICIPANTS:Medical records of children aged 1-15 years receiving care in 2012-2013 were sampled from 57 general practitioners, 34 emergency departments (ED) and 28 hospitals across three Australian states; 6689 medical records were screened for visits for acute abdominal pain and audited by trained paediatric nurses. OUTCOME MEASURES:Adherence to 21 care quality indicators and three bundles of indicators: bundle A-History; bundle B-Examination; bundle C-Imaging. RESULTS:Five hundred and fourteen children had 696 visits for acute abdominal pain and adherence was assessed for 9785 individual indicators. The overall adherence was 69.9% (95% CI 64.8% to 74.6%). Adherence to individual indicators ranged from 21.6% for assessment of dehydration to 91.4% for appropriate ordering of imaging. Adherence was low for bundle A-History (29.4%) and bundle B-Examination (10.2%), and high for bundle C-Imaging (91.4%). Adherence to the 21 indicators overall was significantly lower in general practice (62.7%, 95% CI 57.0% to 68.1%) compared with ED (86.0%, 95% CI 83.4% to 88.4%; p<0.0001) and hospital inpatient settings (87.9%, 95% CI 83.1% to 91.8%; p<0.0001). CONCLUSIONS:There was considerable variation in care quality for indicator bundles and care settings. Future work should explore how validated care quality indicator assessments can be embedded into clinical workflows to support continuous care quality improvement.
journal_name
BMJ Qual Safjournal_title
BMJ quality & safetyauthors
Zurynski Y,Churruca K,Arnolda G,Dalton S,Ting HP,Hibbert PD,Molloy C,Wiles LK,de Wet C,Braithwaite Jdoi
10.1136/bmjqs-2019-010088subject
Has Abstractpub_date
2020-06-01 00:00:00pages
509-516issue
6eissn
2044-5415issn
2044-5423pii
bmjqs-2019-010088journal_volume
29pub_type
杂志文章abstract:OBJECTIVE:The goal of this study was to identify barriers and facilitators to the optimal management of critically ill children who present initially to community hospitals and how best to support the needs of front-line healthcare providers in these settings prior to transfer to the regional academic paediatric health...
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pub_type: 杂志文章
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更新日期:2014-05-01 00:00:00
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doi:10.1136/bmjqs-2014-003158
更新日期:2015-02-01 00:00:00
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pub_type: 杂志文章,评审
doi:10.1136/bmjqs-2011-000150
更新日期:2012-02-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2017-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmjqs-2014-003816
更新日期:2015-08-01 00:00:00
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doi:10.1136/bmjqs-2014-003429
更新日期:2015-02-01 00:00:00
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更新日期:2020-10-23 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjqs.2009.039693
更新日期:2011-09-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章,评审
doi:10.1136/bmjqs-2013-001862
更新日期:2014-04-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs.2009.034926
更新日期:2011-07-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2019-010206
更新日期:2021-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmjqs-2011-051755
更新日期:2012-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2016-12-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2014-06-01 00:00:00