Clinical indicators for common paediatric conditions: Processes, provenance and products of the CareTrack Kids study

Louise K. Wiles, Tamara D. Hooper, Peter D. Hibbert, Charlotte Molloy, Les White, Adam Jaffe, Christopher T. Cowell, Mark F. Harris, William B. Runciman, Annette Schmiede, Chris Dalton, Andrew R. Hallahan, Sarah Dalton, Helena Williams, Gavin Wheaton, Elisabeth Murphy, Jeffrey Braithwaite

Research output: Research - peer-reviewReview article

Abstract

Background In order to determine the extent to which care delivered to children is appropriate (in line with evidence-based care and/or clinical practice guidelines (CPGs)) in Australia, we developed a set of clinical indicators for 21 common paediatric medical conditions for use across a range of primary, secondary and tertiary healthcare practice facilities. Methods Clinical indicators were extracted from recommendations found through systematic searches of national and international guidelines, and formatted with explicit criteria for inclusion, exclusion, time frame and setting. Experts reviewed the indicators using a multi-round modified Delphi process and collaborative online wiki to develop consensus on what constituted appropriate care. Results From 121 clinical practice guidelines, 1098 recommendations were used to draft 451 proposed appropriateness indicators. In total, 61 experts (n = 24 internal reviewers, n = 37 external reviewers) reviewed these indicators over 40 weeks. A final set of 234 indicators resulted, from which 597 indicator items were derived suitable for medical record audit. Most indicator items were geared towards capturing information about under-use in healthcare (n = 551, 92%) across emergency department (n = 457, 77%), hospital (n = 450, 75%) and general practice (n = 434, 73%) healthcare facilities, and based on consensus level recommendations (n = 451, 76%). The main reason for rejecting indicators was ‘feasibility’ (likely to be able to be used for determining compliance with ‘appropriate care’ from medical record audit). Conclusion A set of indicators was developed for the appropriateness of care for 21 paediatric conditions. We describe the processes (methods), provenance (origins and evolution of indicators) and products (indicator characteristics) of creating clinical indicators within the context of Australian healthcare settings. Developing consensus on clinical appropriateness indicators using a Delphi approach and collaborative online wiki has methodological utility. The final indicator set can be used by clinicians and organisations to measure and reflect on their own practice.

LanguageEnglish
Article numbere0209637
JournalPLoS ONE
Volume14
Issue number1
DOIs
StatePublished - 1 Jan 2019

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Wiles, L. K., Hooper, T. D., Hibbert, P. D., Molloy, C., White, L., Jaffe, A., ... Braithwaite, J. (2019). Clinical indicators for common paediatric conditions: Processes, provenance and products of the CareTrack Kids study. PLoS ONE, 14(1), [e0209637]. DOI: 10.1371/journal.pone.0209637
Wiles, Louise K. ; Hooper, Tamara D. ; Hibbert, Peter D. ; Molloy, Charlotte ; White, Les ; Jaffe, Adam ; Cowell, Christopher T. ; Harris, Mark F. ; Runciman, William B. ; Schmiede, Annette ; Dalton, Chris ; Hallahan, Andrew R. ; Dalton, Sarah ; Williams, Helena ; Wheaton, Gavin ; Murphy, Elisabeth ; Braithwaite, Jeffrey. / Clinical indicators for common paediatric conditions : Processes, provenance and products of the CareTrack Kids study. In: PLoS ONE. 2019 ; Vol. 14, No. 1.
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title = "Clinical indicators for common paediatric conditions: Processes, provenance and products of the CareTrack Kids study",
abstract = "Background In order to determine the extent to which care delivered to children is appropriate (in line with evidence-based care and/or clinical practice guidelines (CPGs)) in Australia, we developed a set of clinical indicators for 21 common paediatric medical conditions for use across a range of primary, secondary and tertiary healthcare practice facilities. Methods Clinical indicators were extracted from recommendations found through systematic searches of national and international guidelines, and formatted with explicit criteria for inclusion, exclusion, time frame and setting. Experts reviewed the indicators using a multi-round modified Delphi process and collaborative online wiki to develop consensus on what constituted appropriate care. Results From 121 clinical practice guidelines, 1098 recommendations were used to draft 451 proposed appropriateness indicators. In total, 61 experts (n = 24 internal reviewers, n = 37 external reviewers) reviewed these indicators over 40 weeks. A final set of 234 indicators resulted, from which 597 indicator items were derived suitable for medical record audit. Most indicator items were geared towards capturing information about under-use in healthcare (n = 551, 92%) across emergency department (n = 457, 77%), hospital (n = 450, 75%) and general practice (n = 434, 73%) healthcare facilities, and based on consensus level recommendations (n = 451, 76%). The main reason for rejecting indicators was ‘feasibility’ (likely to be able to be used for determining compliance with ‘appropriate care’ from medical record audit). Conclusion A set of indicators was developed for the appropriateness of care for 21 paediatric conditions. We describe the processes (methods), provenance (origins and evolution of indicators) and products (indicator characteristics) of creating clinical indicators within the context of Australian healthcare settings. Developing consensus on clinical appropriateness indicators using a Delphi approach and collaborative online wiki has methodological utility. The final indicator set can be used by clinicians and organisations to measure and reflect on their own practice.",
author = "Wiles, {Louise K.} and Hooper, {Tamara D.} and Hibbert, {Peter D.} and Charlotte Molloy and Les White and Adam Jaffe and Cowell, {Christopher T.} and Harris, {Mark F.} and Runciman, {William B.} and Annette Schmiede and Chris Dalton and Hallahan, {Andrew R.} and Sarah Dalton and Helena Williams and Gavin Wheaton and Elisabeth Murphy and Jeffrey Braithwaite",
year = "2019",
month = "1",
doi = "10.1371/journal.pone.0209637",
volume = "14",
journal = "PLoS ONE",
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Wiles, LK, Hooper, TD, Hibbert, PD, Molloy, C, White, L, Jaffe, A, Cowell, CT, Harris, MF, Runciman, WB, Schmiede, A, Dalton, C, Hallahan, AR, Dalton, S, Williams, H, Wheaton, G, Murphy, E & Braithwaite, J 2019, 'Clinical indicators for common paediatric conditions: Processes, provenance and products of the CareTrack Kids study' PLoS ONE, vol 14, no. 1, e0209637. DOI: 10.1371/journal.pone.0209637

Clinical indicators for common paediatric conditions : Processes, provenance and products of the CareTrack Kids study. / Wiles, Louise K.; Hooper, Tamara D.; Hibbert, Peter D.; Molloy, Charlotte; White, Les; Jaffe, Adam; Cowell, Christopher T.; Harris, Mark F.; Runciman, William B.; Schmiede, Annette; Dalton, Chris; Hallahan, Andrew R.; Dalton, Sarah; Williams, Helena; Wheaton, Gavin; Murphy, Elisabeth; Braithwaite, Jeffrey.

In: PLoS ONE, Vol. 14, No. 1, e0209637, 01.01.2019.

Research output: Research - peer-reviewReview article

TY - JOUR

T1 - Clinical indicators for common paediatric conditions

T2 - PLoS ONE

AU - Wiles,Louise K.

AU - Hooper,Tamara D.

AU - Hibbert,Peter D.

AU - Molloy,Charlotte

AU - White,Les

AU - Jaffe,Adam

AU - Cowell,Christopher T.

AU - Harris,Mark F.

AU - Runciman,William B.

AU - Schmiede,Annette

AU - Dalton,Chris

AU - Hallahan,Andrew R.

AU - Dalton,Sarah

AU - Williams,Helena

AU - Wheaton,Gavin

AU - Murphy,Elisabeth

AU - Braithwaite,Jeffrey

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background In order to determine the extent to which care delivered to children is appropriate (in line with evidence-based care and/or clinical practice guidelines (CPGs)) in Australia, we developed a set of clinical indicators for 21 common paediatric medical conditions for use across a range of primary, secondary and tertiary healthcare practice facilities. Methods Clinical indicators were extracted from recommendations found through systematic searches of national and international guidelines, and formatted with explicit criteria for inclusion, exclusion, time frame and setting. Experts reviewed the indicators using a multi-round modified Delphi process and collaborative online wiki to develop consensus on what constituted appropriate care. Results From 121 clinical practice guidelines, 1098 recommendations were used to draft 451 proposed appropriateness indicators. In total, 61 experts (n = 24 internal reviewers, n = 37 external reviewers) reviewed these indicators over 40 weeks. A final set of 234 indicators resulted, from which 597 indicator items were derived suitable for medical record audit. Most indicator items were geared towards capturing information about under-use in healthcare (n = 551, 92%) across emergency department (n = 457, 77%), hospital (n = 450, 75%) and general practice (n = 434, 73%) healthcare facilities, and based on consensus level recommendations (n = 451, 76%). The main reason for rejecting indicators was ‘feasibility’ (likely to be able to be used for determining compliance with ‘appropriate care’ from medical record audit). Conclusion A set of indicators was developed for the appropriateness of care for 21 paediatric conditions. We describe the processes (methods), provenance (origins and evolution of indicators) and products (indicator characteristics) of creating clinical indicators within the context of Australian healthcare settings. Developing consensus on clinical appropriateness indicators using a Delphi approach and collaborative online wiki has methodological utility. The final indicator set can be used by clinicians and organisations to measure and reflect on their own practice.

AB - Background In order to determine the extent to which care delivered to children is appropriate (in line with evidence-based care and/or clinical practice guidelines (CPGs)) in Australia, we developed a set of clinical indicators for 21 common paediatric medical conditions for use across a range of primary, secondary and tertiary healthcare practice facilities. Methods Clinical indicators were extracted from recommendations found through systematic searches of national and international guidelines, and formatted with explicit criteria for inclusion, exclusion, time frame and setting. Experts reviewed the indicators using a multi-round modified Delphi process and collaborative online wiki to develop consensus on what constituted appropriate care. Results From 121 clinical practice guidelines, 1098 recommendations were used to draft 451 proposed appropriateness indicators. In total, 61 experts (n = 24 internal reviewers, n = 37 external reviewers) reviewed these indicators over 40 weeks. A final set of 234 indicators resulted, from which 597 indicator items were derived suitable for medical record audit. Most indicator items were geared towards capturing information about under-use in healthcare (n = 551, 92%) across emergency department (n = 457, 77%), hospital (n = 450, 75%) and general practice (n = 434, 73%) healthcare facilities, and based on consensus level recommendations (n = 451, 76%). The main reason for rejecting indicators was ‘feasibility’ (likely to be able to be used for determining compliance with ‘appropriate care’ from medical record audit). Conclusion A set of indicators was developed for the appropriateness of care for 21 paediatric conditions. We describe the processes (methods), provenance (origins and evolution of indicators) and products (indicator characteristics) of creating clinical indicators within the context of Australian healthcare settings. Developing consensus on clinical appropriateness indicators using a Delphi approach and collaborative online wiki has methodological utility. The final indicator set can be used by clinicians and organisations to measure and reflect on their own practice.

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M3 - Review article

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SN - 1932-6203

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Wiles LK, Hooper TD, Hibbert PD, Molloy C, White L, Jaffe A et al. Clinical indicators for common paediatric conditions: Processes, provenance and products of the CareTrack Kids study. PLoS ONE. 2019 Jan 1;14(1). e0209637. Available from, DOI: 10.1371/journal.pone.0209637