TY - JOUR
T1 - Development of a Quality Indicator Set for the Optimal Acute Management of Moderate to Severe Traumatic Brain Injury in the Australian Context
AU - Jeffcote, Toby
AU - Battistuzzo, Camila R.
AU - Roach, Rebecca
AU - Bell, Catherine
AU - Bendinelli, Cino
AU - Rashford, Stephen
AU - Jithoo, Ron
AU - Gabbe, Belinda J.
AU - Flower, Oliver
AU - O’Reilly, Gerard
AU - Campbell, Lewis T.
AU - Cooper, D. James
AU - Balogh, Zsolt J.
AU - Udy, Andrew A.
AU - Delphi panel
AU - Chow, Andrew
AU - Delaney, Anthony
AU - Hooper, Andrew
AU - Nadkarni, Aniket
AU - Poulter, Amber Louise J.
AU - Wells, Adam
AU - Reddi, Benjamin
AU - Mitra, Biswadev
AU - Sheridan, Brad
AU - Burns, Brian
AU - Rienecker, Carly
AU - Bodnar, Daniel
AU - Bowen, David
AU - Gantner, Dashiell
AU - Nasrallah, Fatima
AU - Healy, Geoffrey
AU - Ryan, Gleen
AU - Anstey, James R.
AU - Hsu, Jeremy
AU - Bellapart, Judith
AU - King, Kate
AU - Harbour, Kelly
AU - Jeffree, Rosalind L.
AU - Bihari, Shailesh
AU - Fitzgerald, Melinda
AU - Noonan, Michael
AU - Plummer, Mark
AU - Reade, Michael C.
AU - Waak, Michaela
AU - Weeden, Mark
AU - Cooper, Paul David
AU - Cameron, Peter
AU - Bellomo, Rinaldo
AU - McNamara, Robert
AU - McGloughlin, Stephen
AU - O’Brien, Terence J.
AU - Withers, Teresa
AU - Westerlund, Torg
PY - 2025/4
Y1 - 2025/4
N2 - Background: The aim of this study was to develop a consensus-based set of indicators of high-quality acute moderate to severe traumatic brain injury (msTBI) clinical management that can be used to measure structure, process, and outcome factors that are likely to influence patient outcomes. This is the first stage of the PRECISION-TBI program, which is a prospective cohort study that aims to identify and promote optimal clinical management of msTBI in Australia. Methods: A preliminary set of 45 quality indicators was developed based on available evidence. An advisory committee of established experts in the field refined the initial indicator set in terms of content coverage, proportional representation, contamination, and supporting evidence. The refined indicator set was then distributed to a wider Delphi panel for assessment of each indicator in terms of validity, measurement feasibility, variability, and action feasibility. Inclusion in the final indicator set was contingent on prespecified inclusion scoring. Results: The indicator set was structured according to the care pathway of msTBI and included prehospital, emergency department, neurosurgical, intensive care, and rehabilitation indicators. Measurement domains included structure indicators, logistic indicators, and clinical management indicators. The Delphi panel consisted of 44 participants (84% physician, 12% nursing, and 4% primary research) with a median of 15 years of practice. Of the 47 indicators included in the second round of the Delphi, 32 indicators were approved by the Delphi group. Conclusions: This study identified a set of 32 quality indicators that can be used to structure data collection to drive quality improvement in the clinical management of msTBI. They will also be used to guide feedback to PRECISION-TBI’s participating sites.
AB - Background: The aim of this study was to develop a consensus-based set of indicators of high-quality acute moderate to severe traumatic brain injury (msTBI) clinical management that can be used to measure structure, process, and outcome factors that are likely to influence patient outcomes. This is the first stage of the PRECISION-TBI program, which is a prospective cohort study that aims to identify and promote optimal clinical management of msTBI in Australia. Methods: A preliminary set of 45 quality indicators was developed based on available evidence. An advisory committee of established experts in the field refined the initial indicator set in terms of content coverage, proportional representation, contamination, and supporting evidence. The refined indicator set was then distributed to a wider Delphi panel for assessment of each indicator in terms of validity, measurement feasibility, variability, and action feasibility. Inclusion in the final indicator set was contingent on prespecified inclusion scoring. Results: The indicator set was structured according to the care pathway of msTBI and included prehospital, emergency department, neurosurgical, intensive care, and rehabilitation indicators. Measurement domains included structure indicators, logistic indicators, and clinical management indicators. The Delphi panel consisted of 44 participants (84% physician, 12% nursing, and 4% primary research) with a median of 15 years of practice. Of the 47 indicators included in the second round of the Delphi, 32 indicators were approved by the Delphi group. Conclusions: This study identified a set of 32 quality indicators that can be used to structure data collection to drive quality improvement in the clinical management of msTBI. They will also be used to guide feedback to PRECISION-TBI’s participating sites.
KW - Benchmarking
KW - Critical care
KW - Quality indicators
KW - Quality of care
KW - Traumatic brain injuries
UR - http://www.scopus.com/inward/record.url?scp=85203349856&partnerID=8YFLogxK
U2 - 10.1007/s12028-024-02107-x
DO - 10.1007/s12028-024-02107-x
M3 - Article
AN - SCOPUS:85203349856
SN - 1541-6933
VL - 42
SP - 485
EP - 494
JO - Neurocritical Care
JF - Neurocritical Care
IS - 2
ER -