Development of key performance indicators for emergency departments in Ireland using an electronic modified-Delphi consensus approach.

Hdl Handle:
http://hdl.handle.net/10147/229155
Title:
Development of key performance indicators for emergency departments in Ireland using an electronic modified-Delphi consensus approach.
Authors:
Wakai, Abel; O'Sullivan, Ronan; Staunton, Paul; Walsh, Cathal; Hickey, Fergal; Plunkett, Patrick K
Affiliation:
aEmergency Care Research Unit (ECRU), Department of Emergency Medicine, Midland Regional Hospital, Tullamore bEmergency Department, Our Lady's Children's Hospital, Crumlin cDepartment of Paediatrics, University College Dublin (UCD) dDepartment of Emergency Medicine, Beaumont Hospital eDepartment of Statistics, Trinity College, Dublin fDepartment of Emergency Medicine, Sligo General Hospital, Sligo gDepartment of Emergency Medicine, St James's Hospital/School of Medicine, Faculty of Health Sciences, Trinity College, Dublin, Ireland.
Citation:
Development of key performance indicators for emergency departments in Ireland using an electronic modified-Delphi consensus approach. 2012:notEur J Emerg Med
Journal:
European journal of emergency medicine : official journal of the European Society for Emergency Medicine
Issue Date:
29-Feb-2012
URI:
http://hdl.handle.net/10147/229155
DOI:
10.1097/MEJ.0b013e328351e5d8
PubMed ID:
22382650
Abstract:
OBJECTIVE: The objective of this study was to develop a consensus among emergency medicine (EM) specialists working in Ireland for emergency department (ED) key performance indicators (KPIs). METHODS: The method employed was a three-round electronic modified-Delphi process. An online questionnaire with 54 potential KPIs was set up for round 1 of the Delphi process. The Delphi panel consisted of all registered EM specialists in Ireland. Each indicator on the questionnaire was rated using a five-point Likert-type rating scale. Agreement was defined as at least 70% of the responders rating an indicator as 'agree' or 'strongly agree' on the rating scale. Data were analysed using standard descriptive statistics. Data were also analysed as the mean of the Likert rating with 95% confidence intervals (95% CIs). Sensitivity of the ratings was examined for robustness by bootstrapping the original sample. Statistical analyses were carried out using SPSS version 16.0. RESULTS: The response rates in rounds 1, 2 and 3 were 86, 88 and 88%, respectively. Ninety-seven potential indicators reached agreement after the three rounds. In the context of the Donabedian structure-process-outcome framework of performance indicators, 41 (42%) of the agreed indicators were structure indicators, 52 (54%) were process indicators and four (4%) were outcome indicators. Overall, the top-three highest rated indicators were: presence of a dedicated ED clinical information system (4.7; 95% CI 4.6-4.9), ED compliance with minimum design standards (4.7; 95% CI 4.5-4.8) and time from ED arrival to first ECG in suspected cardiac chest pain (4.7; 95% CI 4.5-4.9). The top-three highest rated indicators specific to clinical care of children in EDs were: time to administration of antibiotics in children with suspected bacterial meningitis (4.6; 95% CI 4.5-4.8), separate area available within EDs (seeing both adults and children) to assess children (4.4; 95% CI 4.2-4.6) and time to administration of analgesia in children with forearm fractures (4.4; 95% CI 4.2-4.7). CONCLUSION: Employing a Delphi consensus process, it was possible to reach a consensus among EM specialists in Ireland on a suite of 97 KPIs for EDs.
Item Type:
Article
Language:
en
ISSN:
1473-5695

Full metadata record

DC FieldValue Language
dc.contributor.authorWakai, Abelen_GB
dc.contributor.authorO'Sullivan, Ronanen_GB
dc.contributor.authorStaunton, Paulen_GB
dc.contributor.authorWalsh, Cathalen_GB
dc.contributor.authorHickey, Fergalen_GB
dc.contributor.authorPlunkett, Patrick Ken_GB
dc.date.accessioned2012-06-15T15:12:32Z-
dc.date.available2012-06-15T15:12:32Z-
dc.date.issued2012-02-29-
dc.identifier.citationDevelopment of key performance indicators for emergency departments in Ireland using an electronic modified-Delphi consensus approach. 2012:notEur J Emerg Meden_GB
dc.identifier.issn1473-5695-
dc.identifier.pmid22382650-
dc.identifier.doi10.1097/MEJ.0b013e328351e5d8-
dc.identifier.urihttp://hdl.handle.net/10147/229155-
dc.description.abstractOBJECTIVE: The objective of this study was to develop a consensus among emergency medicine (EM) specialists working in Ireland for emergency department (ED) key performance indicators (KPIs). METHODS: The method employed was a three-round electronic modified-Delphi process. An online questionnaire with 54 potential KPIs was set up for round 1 of the Delphi process. The Delphi panel consisted of all registered EM specialists in Ireland. Each indicator on the questionnaire was rated using a five-point Likert-type rating scale. Agreement was defined as at least 70% of the responders rating an indicator as 'agree' or 'strongly agree' on the rating scale. Data were analysed using standard descriptive statistics. Data were also analysed as the mean of the Likert rating with 95% confidence intervals (95% CIs). Sensitivity of the ratings was examined for robustness by bootstrapping the original sample. Statistical analyses were carried out using SPSS version 16.0. RESULTS: The response rates in rounds 1, 2 and 3 were 86, 88 and 88%, respectively. Ninety-seven potential indicators reached agreement after the three rounds. In the context of the Donabedian structure-process-outcome framework of performance indicators, 41 (42%) of the agreed indicators were structure indicators, 52 (54%) were process indicators and four (4%) were outcome indicators. Overall, the top-three highest rated indicators were: presence of a dedicated ED clinical information system (4.7; 95% CI 4.6-4.9), ED compliance with minimum design standards (4.7; 95% CI 4.5-4.8) and time from ED arrival to first ECG in suspected cardiac chest pain (4.7; 95% CI 4.5-4.9). The top-three highest rated indicators specific to clinical care of children in EDs were: time to administration of antibiotics in children with suspected bacterial meningitis (4.6; 95% CI 4.5-4.8), separate area available within EDs (seeing both adults and children) to assess children (4.4; 95% CI 4.2-4.6) and time to administration of analgesia in children with forearm fractures (4.4; 95% CI 4.2-4.7). CONCLUSION: Employing a Delphi consensus process, it was possible to reach a consensus among EM specialists in Ireland on a suite of 97 KPIs for EDs.en_GB
dc.languageENG-
dc.language.isoenen
dc.rightsArchived with thanks to European journal of emergency medicine : official journal of the European Society for Emergency Medicineen_GB
dc.titleDevelopment of key performance indicators for emergency departments in Ireland using an electronic modified-Delphi consensus approach.en_GB
dc.typeArticleen
dc.contributor.departmentaEmergency Care Research Unit (ECRU), Department of Emergency Medicine, Midland Regional Hospital, Tullamore bEmergency Department, Our Lady's Children's Hospital, Crumlin cDepartment of Paediatrics, University College Dublin (UCD) dDepartment of Emergency Medicine, Beaumont Hospital eDepartment of Statistics, Trinity College, Dublin fDepartment of Emergency Medicine, Sligo General Hospital, Sligo gDepartment of Emergency Medicine, St James's Hospital/School of Medicine, Faculty of Health Sciences, Trinity College, Dublin, Ireland.en_GB
dc.identifier.journalEuropean journal of emergency medicine : official journal of the European Society for Emergency Medicineen_GB
dc.description.provinceLeinsteren

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