Development of Quality Measures for Pediatric Agitation Management in the Emergency Department

Jennifer A. Hoffmann*, Julie K. Johnson, Alba Pergjika, Elizabeth R. Alpern, Jacqueline B. Corboy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

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 languageEnglish (US)
Pages (from-to)218-229
Number of pages12
JournalJournal for Healthcare Quality
Volume44
Issue number4
DOIs
StatePublished - 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

Fingerprint

Dive into the research topics of 'Development of Quality Measures for Pediatric Agitation Management in the Emergency Department'. Together they form a unique fingerprint.

Cite this