Quality of Care Indicators in Patients with Acute Pancreatitis

Gyanprakash Ketwaroo, Robert Jay Sealock, Steven Freedman, Phil A. Hart, Mohamed Othman, Wahid Wassef, Peter Banks, Santhi Swaroop Vege, Timothy Gardner, Dhiraj Yadav, Sunil Sheth, Fasiha Kanwal

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Acute pancreatitis (AP) is a common and expensive condition. Improving quality of care in AP is vital to minimizing cost and improving patient outcomes. However, there has been little work accomplished toward developing and validating explicit quality indicators (QIs) in AP. Aims: To define quality of care in patients with AP by developing explicit QIs using standardized techniques. Methods: We used the UCLA/RAND Delphi panel approach to combine a comprehensive literature review with the collective judgment of experts to identify a defined set of process measures for AP. Results: We produced 164 candidate QIs after a comprehensive literature review. After Delphi review, 75 had a median rating ≥ 7. We excluded 11 QIs where the disagreement index exceeded 1.0 and combined indicators overlapping in content to produce a final list of 22 QIs. Overall, 8 QIs related to diagnosis, prevention, or determination of etiology, 2 QIs focused on determination of severity, 3 QIs captured fluid resuscitation, 2 QIs measured nutrition, 1 QI use of antibiotics, and 6 QIs captured endoscopic or surgical management. Conclusions: We have developed 22 QIs spanning the spectrum of AP management including diagnosis, risk stratification, and pharmacological and endoscopic therapy. These QIs will facilitate future quality improvement by practitioners and organizations who treat patients with AP and further identify areas that are amenable to improvement to enhance patient care. We anticipate that this QI set will represent the first step in determining a framework for demonstrating value in the care of patients with AP.

Original languageEnglish (US)
JournalDigestive Diseases and Sciences
DOIs
StatePublished - Jan 1 2019

Fingerprint

Quality of Health Care
Pancreatitis
Patient Care
Process Assessment (Health Care)
Quality Improvement
Resuscitation
Organizations
Pharmacology
Anti-Bacterial Agents
Costs and Cost Analysis

Keywords

  • Acute pancreatitis
  • Delphi
  • Quality
  • Quality improvement

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

Cite this

Ketwaroo, G., Sealock, R. J., Freedman, S., Hart, P. A., Othman, M., Wassef, W., ... Kanwal, F. (2019). Quality of Care Indicators in Patients with Acute Pancreatitis. Digestive Diseases and Sciences. https://doi.org/10.1007/s10620-019-05674-8

Quality of Care Indicators in Patients with Acute Pancreatitis. / Ketwaroo, Gyanprakash; Sealock, Robert Jay; Freedman, Steven; Hart, Phil A.; Othman, Mohamed; Wassef, Wahid; Banks, Peter; Vege, Santhi Swaroop; Gardner, Timothy; Yadav, Dhiraj; Sheth, Sunil; Kanwal, Fasiha.

In: Digestive Diseases and Sciences, 01.01.2019.

Research output: Contribution to journalArticle

Ketwaroo, G, Sealock, RJ, Freedman, S, Hart, PA, Othman, M, Wassef, W, Banks, P, Vege, SS, Gardner, T, Yadav, D, Sheth, S & Kanwal, F 2019, 'Quality of Care Indicators in Patients with Acute Pancreatitis', Digestive Diseases and Sciences. https://doi.org/10.1007/s10620-019-05674-8
Ketwaroo, Gyanprakash ; Sealock, Robert Jay ; Freedman, Steven ; Hart, Phil A. ; Othman, Mohamed ; Wassef, Wahid ; Banks, Peter ; Vege, Santhi Swaroop ; Gardner, Timothy ; Yadav, Dhiraj ; Sheth, Sunil ; Kanwal, Fasiha. / Quality of Care Indicators in Patients with Acute Pancreatitis. In: Digestive Diseases and Sciences. 2019.
@article{68442ed5e34f4f1ab55445622300f4ab,
title = "Quality of Care Indicators in Patients with Acute Pancreatitis",
abstract = "Background: Acute pancreatitis (AP) is a common and expensive condition. Improving quality of care in AP is vital to minimizing cost and improving patient outcomes. However, there has been little work accomplished toward developing and validating explicit quality indicators (QIs) in AP. Aims: To define quality of care in patients with AP by developing explicit QIs using standardized techniques. Methods: We used the UCLA/RAND Delphi panel approach to combine a comprehensive literature review with the collective judgment of experts to identify a defined set of process measures for AP. Results: We produced 164 candidate QIs after a comprehensive literature review. After Delphi review, 75 had a median rating ≥ 7. We excluded 11 QIs where the disagreement index exceeded 1.0 and combined indicators overlapping in content to produce a final list of 22 QIs. Overall, 8 QIs related to diagnosis, prevention, or determination of etiology, 2 QIs focused on determination of severity, 3 QIs captured fluid resuscitation, 2 QIs measured nutrition, 1 QI use of antibiotics, and 6 QIs captured endoscopic or surgical management. Conclusions: We have developed 22 QIs spanning the spectrum of AP management including diagnosis, risk stratification, and pharmacological and endoscopic therapy. These QIs will facilitate future quality improvement by practitioners and organizations who treat patients with AP and further identify areas that are amenable to improvement to enhance patient care. We anticipate that this QI set will represent the first step in determining a framework for demonstrating value in the care of patients with AP.",
keywords = "Acute pancreatitis, Delphi, Quality, Quality improvement",
author = "Gyanprakash Ketwaroo and Sealock, {Robert Jay} and Steven Freedman and Hart, {Phil A.} and Mohamed Othman and Wahid Wassef and Peter Banks and Vege, {Santhi Swaroop} and Timothy Gardner and Dhiraj Yadav and Sunil Sheth and Fasiha Kanwal",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s10620-019-05674-8",
language = "English (US)",
journal = "Digestive Diseases and Sciences",
issn = "0163-2116",
publisher = "Springer New York",

}

TY - JOUR

T1 - Quality of Care Indicators in Patients with Acute Pancreatitis

AU - Ketwaroo, Gyanprakash

AU - Sealock, Robert Jay

AU - Freedman, Steven

AU - Hart, Phil A.

AU - Othman, Mohamed

AU - Wassef, Wahid

AU - Banks, Peter

AU - Vege, Santhi Swaroop

AU - Gardner, Timothy

AU - Yadav, Dhiraj

AU - Sheth, Sunil

AU - Kanwal, Fasiha

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Acute pancreatitis (AP) is a common and expensive condition. Improving quality of care in AP is vital to minimizing cost and improving patient outcomes. However, there has been little work accomplished toward developing and validating explicit quality indicators (QIs) in AP. Aims: To define quality of care in patients with AP by developing explicit QIs using standardized techniques. Methods: We used the UCLA/RAND Delphi panel approach to combine a comprehensive literature review with the collective judgment of experts to identify a defined set of process measures for AP. Results: We produced 164 candidate QIs after a comprehensive literature review. After Delphi review, 75 had a median rating ≥ 7. We excluded 11 QIs where the disagreement index exceeded 1.0 and combined indicators overlapping in content to produce a final list of 22 QIs. Overall, 8 QIs related to diagnosis, prevention, or determination of etiology, 2 QIs focused on determination of severity, 3 QIs captured fluid resuscitation, 2 QIs measured nutrition, 1 QI use of antibiotics, and 6 QIs captured endoscopic or surgical management. Conclusions: We have developed 22 QIs spanning the spectrum of AP management including diagnosis, risk stratification, and pharmacological and endoscopic therapy. These QIs will facilitate future quality improvement by practitioners and organizations who treat patients with AP and further identify areas that are amenable to improvement to enhance patient care. We anticipate that this QI set will represent the first step in determining a framework for demonstrating value in the care of patients with AP.

AB - Background: Acute pancreatitis (AP) is a common and expensive condition. Improving quality of care in AP is vital to minimizing cost and improving patient outcomes. However, there has been little work accomplished toward developing and validating explicit quality indicators (QIs) in AP. Aims: To define quality of care in patients with AP by developing explicit QIs using standardized techniques. Methods: We used the UCLA/RAND Delphi panel approach to combine a comprehensive literature review with the collective judgment of experts to identify a defined set of process measures for AP. Results: We produced 164 candidate QIs after a comprehensive literature review. After Delphi review, 75 had a median rating ≥ 7. We excluded 11 QIs where the disagreement index exceeded 1.0 and combined indicators overlapping in content to produce a final list of 22 QIs. Overall, 8 QIs related to diagnosis, prevention, or determination of etiology, 2 QIs focused on determination of severity, 3 QIs captured fluid resuscitation, 2 QIs measured nutrition, 1 QI use of antibiotics, and 6 QIs captured endoscopic or surgical management. Conclusions: We have developed 22 QIs spanning the spectrum of AP management including diagnosis, risk stratification, and pharmacological and endoscopic therapy. These QIs will facilitate future quality improvement by practitioners and organizations who treat patients with AP and further identify areas that are amenable to improvement to enhance patient care. We anticipate that this QI set will represent the first step in determining a framework for demonstrating value in the care of patients with AP.

KW - Acute pancreatitis

KW - Delphi

KW - Quality

KW - Quality improvement

UR - http://www.scopus.com/inward/record.url?scp=85066790392&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85066790392&partnerID=8YFLogxK

U2 - 10.1007/s10620-019-05674-8

DO - 10.1007/s10620-019-05674-8

M3 - Article

C2 - 31152333

AN - SCOPUS:85066790392

JO - Digestive Diseases and Sciences

JF - Digestive Diseases and Sciences

SN - 0163-2116

ER -