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 Scopus citations

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)
Pages (from-to)2514-2526
Number of pages13
JournalDigestive diseases and sciences
Volume64
Issue number9
DOIs
StatePublished - Sep 15 2019

Keywords

  • Acute pancreatitis
  • Delphi
  • Quality
  • Quality improvement

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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  • Cite this

    Ketwaroo, G., Sealock, R. J., Freedman, S., Hart, P. A., Othman, M., Wassef, W., Banks, P., Vege, S. S., Gardner, T., Yadav, D., Sheth, S., & Kanwal, F. (2019). Quality of Care Indicators in Patients with Acute Pancreatitis. Digestive diseases and sciences, 64(9), 2514-2526. https://doi.org/10.1007/s10620-019-05674-8