Abstract
Objective:Pediatric mental health emergency department (ED) visits that involve restraints for agitation are increasing. Quality measures are used to assess and improve healthcare quality. Our objective was to develop quality measures for pediatric ED agitation management informed by multidisciplinary perspectives.Methods:A multidisciplinary panel developed quality measures for pediatric ED agitation management through the modified Delphi method. Panelists ranked measures in importance and feasibility on a 9-point scale during 2 survey rounds, with a teleconference discussion between surveys. Consensus was defined by >75% of panelists ranking a quality measure highly (≥7) in importance and a median feasibility score of ≥4.Results:Panelists included 36 physicians, nurses, social workers, security, child life specialists, hospital data analysts, and parents. The panel reached consensus on 20 quality measures. Measures with the highest percentage of scores with importance ≥7 were related to adverse medication events, patients restrained, staff/patient injuries, reescalation plans, presence of an algorithm to standardize care, formal staff training on deescalation techniques, time to medication administration, and room safety.Conclusions:Twenty quality measures that incorporate multidisciplinary perspectives were developed for pediatric ED agitation management. Once operationalized and field tested, these measures may be used to assess and improve healthcare quality for pediatric agitation.
Original language | English (US) |
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Pages (from-to) | 218-229 |
Number of pages | 12 |
Journal | Journal for Healthcare Quality |
Volume | 44 |
Issue number | 4 |
DOIs | |
State | Published - Jul 1 2022 |
Funding
Dr. J. A. Hoffmann was supported by the Agency for Healthcare Research and Quality under 5K12HS026385-03. REDCap is supported at the Feinberg School of Medicine by the Northwestern University Clinical and Translational Science Institute. Research reported in this publication was supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funders did not participate in the work.
Keywords
- agitation
- emergency medicine
- mental health
- pediatrics
- quality measure
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Health Policy