Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensus
Abstract Background Hospitalized pediatric hematology‐oncology (PHO) patients are at high risk for critical illness, especially in resource‐limited settings. Unfortunately, there are no established quality indicators to guide institutional improvement for these patients. The objective of this study...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-10-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.3351 |
| _version_ | 1826937820012347392 |
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| author | Anita V. Arias Marcela Garza Srinivas Murthy Adolfo Cardenas Franco Diaz Erika Montalvo Katie R. Nielsen Teresa Kortz Rana Sharara‐Chami Paola Friedrich Jennifer McArthur Asya Agulnik |
| author_facet | Anita V. Arias Marcela Garza Srinivas Murthy Adolfo Cardenas Franco Diaz Erika Montalvo Katie R. Nielsen Teresa Kortz Rana Sharara‐Chami Paola Friedrich Jennifer McArthur Asya Agulnik |
| author_sort | Anita V. Arias |
| collection | DOAJ |
| description | Abstract Background Hospitalized pediatric hematology‐oncology (PHO) patients are at high risk for critical illness, especially in resource‐limited settings. Unfortunately, there are no established quality indicators to guide institutional improvement for these patients. The objective of this study was to identify quality indicators to include in PROACTIVE (PediatRic Oncology cApaCity assessment Tool for IntensiVe carE), an assessment tool to evaluate the capacity and quality of pediatric critical care services offered to PHO patients. Methods A comprehensive literature review identified relevant indicators in the areas of structure, performance, and outcomes. An international focus group sorted potential indicators using the framework of domains and subdomains. A modified, three‐round Delphi was conducted among 36 international experts with diverse experience in PHO and critical care in high‐resource and resource‐limited settings. Quality indicators were ranked on relevance and actionability via electronically distributed surveys. Results PROACTIVE contains 119 indicators among eight domains and 22 subdomains, with high‐median importance (≥7) in both relevance and actionability, and ≥80% evaluator agreement. The top five indicators were: (a) A designated PICU area; (b) Availability of a pediatric intensivist; (c) A PHO physician as part of the primary team caring for critically ill PHO patients; (d) Trained nursing staff in pediatric critical care; and (e) Timely PICU transfer of hospitalized PHO patients requiring escalation of care. Conclusions PROACTIVE is a consensus‐derived tool to assess the capacity and quality of pediatric onco‐critical care in resource‐limited settings. Future endeavors include validation of PROACTIVE by correlating the proposed indicators to clinical outcomes and its implementation to identify service delivery gaps amenable to improvement. |
| first_indexed | 2024-04-09T15:56:59Z |
| format | Article |
| id | doaj.art-1ee4f0b0200c45e1810fc54d12620fd3 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2025-02-17T18:47:44Z |
| publishDate | 2020-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-1ee4f0b0200c45e1810fc54d12620fd32024-12-11T08:05:11ZengWileyCancer Medicine2045-76342020-10-019196984699510.1002/cam4.3351Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensusAnita V. Arias0Marcela Garza1Srinivas Murthy2Adolfo Cardenas3Franco Diaz4Erika Montalvo5Katie R. Nielsen6Teresa Kortz7Rana Sharara‐Chami8Paola Friedrich9Jennifer McArthur10Asya Agulnik11Division of Pediatric Critical Care University of Tennessee Health Science Center Memphis TN USADepartment of Global Pediatric Medicine St. Jude Children’s Research Hospital Memphis TN USADepartment of Pediatrics University of British Columbia Vancouver BC CanadaHospital Infantil Teletón de Oncología (HITO) Querétaro MéxicoFacultad de Medicina Clínica Alemana Universidad del Desarrollo Santiago ChilePediatric Critical Care Unit SOLCA Quito Quito EcuadorDivision of Pediatric Critical Care University of Washington Seattle WA USADivision of Pediatric Critical Care University of California San Francisco San Francisco CA USADepartment of Pediatric and Adolescent Medicine American University of Beirut Medical Center Beirut LebanonDepartment of Global Pediatric Medicine St. Jude Children’s Research Hospital Memphis TN USADivision of Pediatric Critical Care St. Jude Children’s Research Hospital Memphis TN USADepartment of Global Pediatric Medicine St. Jude Children’s Research Hospital Memphis TN USAAbstract Background Hospitalized pediatric hematology‐oncology (PHO) patients are at high risk for critical illness, especially in resource‐limited settings. Unfortunately, there are no established quality indicators to guide institutional improvement for these patients. The objective of this study was to identify quality indicators to include in PROACTIVE (PediatRic Oncology cApaCity assessment Tool for IntensiVe carE), an assessment tool to evaluate the capacity and quality of pediatric critical care services offered to PHO patients. Methods A comprehensive literature review identified relevant indicators in the areas of structure, performance, and outcomes. An international focus group sorted potential indicators using the framework of domains and subdomains. A modified, three‐round Delphi was conducted among 36 international experts with diverse experience in PHO and critical care in high‐resource and resource‐limited settings. Quality indicators were ranked on relevance and actionability via electronically distributed surveys. Results PROACTIVE contains 119 indicators among eight domains and 22 subdomains, with high‐median importance (≥7) in both relevance and actionability, and ≥80% evaluator agreement. The top five indicators were: (a) A designated PICU area; (b) Availability of a pediatric intensivist; (c) A PHO physician as part of the primary team caring for critically ill PHO patients; (d) Trained nursing staff in pediatric critical care; and (e) Timely PICU transfer of hospitalized PHO patients requiring escalation of care. Conclusions PROACTIVE is a consensus‐derived tool to assess the capacity and quality of pediatric onco‐critical care in resource‐limited settings. Future endeavors include validation of PROACTIVE by correlating the proposed indicators to clinical outcomes and its implementation to identify service delivery gaps amenable to improvement.https://doi.org/10.1002/cam4.3351clinical cancer researchpediatric cancertranslational research |
| spellingShingle | Anita V. Arias Marcela Garza Srinivas Murthy Adolfo Cardenas Franco Diaz Erika Montalvo Katie R. Nielsen Teresa Kortz Rana Sharara‐Chami Paola Friedrich Jennifer McArthur Asya Agulnik Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensus Cancer Medicine clinical cancer research pediatric cancer translational research |
| title | Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensus |
| title_full | Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensus |
| title_fullStr | Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensus |
| title_full_unstemmed | Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensus |
| title_short | Quality and capacity indicators for hospitalized pediatric oncology patients with critical illness: A modified delphi consensus |
| title_sort | quality and capacity indicators for hospitalized pediatric oncology patients with critical illness a modified delphi consensus |
| topic | clinical cancer research pediatric cancer translational research |
| url | https://doi.org/10.1002/cam4.3351 |
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