A Modified Delphi Process to Identify Process of Care Indicators for the Identification, Prevention and Management of Acute Kidney Injury after Major Surgery
Background: The outcomes of acute kidney injury (AKI) are well appreciated. However, valid indicators of high quality processes of care for AKI after major surgery are lacking. Objectives: To identify indicators of high quality processes of care related to AKI prevention, identification, and managem...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2015-04-01
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| Series: | Canadian Journal of Kidney Health and Disease |
| Online Access: | https://doi.org/10.1186/s40697-015-0047-8 |
| _version_ | 1828871118138638336 |
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| author | Matthew T James Neesh Pannu Rebecca Barry Divya Karsanji Marcello Tonelli Brenda R Hemmelgarn Braden J Manns Sean M Bagshaw H Tom Stelfox Elijah Dixon |
| author_facet | Matthew T James Neesh Pannu Rebecca Barry Divya Karsanji Marcello Tonelli Brenda R Hemmelgarn Braden J Manns Sean M Bagshaw H Tom Stelfox Elijah Dixon |
| author_sort | Matthew T James |
| collection | DOAJ |
| description | Background: The outcomes of acute kidney injury (AKI) are well appreciated. However, valid indicators of high quality processes of care for AKI after major surgery are lacking. Objectives: To identify indicators of high quality processes of care related to AKI prevention, identification, and management after major surgery. Design: A three stage modified Delphi process. Setting: The study was conducted in Alberta, Canada using an online format. Participants: A panel of care providers from surgery, critical care, and nephrology. Measurements: The degree of validity of candidate indicators were rated by panelists on a 7-point Likert scale that ranged from “strongly disagree” to “strongly agree”. Methods: A focused literature review was performed to identify candidate indicators. A modified Delphi process, with three rounds, was used to obtain expert consensus on the validity of potential process of care quality indicators. Results: Thirty-three physicians participated (6 from surgery, 10 from critical care, and 17 from nephrology). A list of 58 potential process of care quality indicators for AKI after surgery was generated including 28 indicators from the initial literature review and 30 indicators suggested by panelists. Following the third round of questioning, 40 process of care indicators were identified with a high level of agreement for face validity; 16 of these reached high consensus among all panelists. Limitations: The consensus of panelists from Alberta, Canada may not be generalizable to other settings. The modified Delphi process did not focus on the feasibility of measuring these process indicators. Conclusions: These indicators can be used to measure and improve the quality of care for AKI after major surgery. |
| first_indexed | 2024-12-13T06:25:10Z |
| format | Article |
| id | doaj.art-ab56f3b7c09a4909aa0d39642d5955f1 |
| institution | Directory Open Access Journal |
| issn | 2054-3581 |
| language | English |
| last_indexed | 2024-12-13T06:25:10Z |
| publishDate | 2015-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Canadian Journal of Kidney Health and Disease |
| spelling | doaj.art-ab56f3b7c09a4909aa0d39642d5955f12022-12-21T23:56:45ZengSAGE PublishingCanadian Journal of Kidney Health and Disease2054-35812015-04-01210.1186/s40697-015-0047-8A Modified Delphi Process to Identify Process of Care Indicators for the Identification, Prevention and Management of Acute Kidney Injury after Major SurgeryMatthew T James0Neesh Pannu1Rebecca Barry2Divya Karsanji3Marcello Tonelli4Brenda R Hemmelgarn5Braden J Manns6Sean M Bagshaw7H Tom Stelfox8Elijah Dixon9 Division of Nephrology, Departments of Medicine and Community Health Sciences, University of Calgary, Calgary T2N 2 T9, AB, Canada Department of Medicine, University of Alberta, Edmonton, Canada Department of Medicine, University of Calgary, Calgary, Canada Department of Medicine, University of Calgary, Calgary, Canada Department of Medicine, University of Calgary, Calgary, Canada Department of Community Health Sciences, University of Calgary, Calgary, Canada Department of Community Health Sciences, University of Calgary, Calgary, Canada Department of Critical Care, University of Alberta, Edmonton, Canada Department of Critical Care, University of Calgary, Calgary, Canada Department of Surgery, University of Calgary, Calgary, CanadaBackground: The outcomes of acute kidney injury (AKI) are well appreciated. However, valid indicators of high quality processes of care for AKI after major surgery are lacking. Objectives: To identify indicators of high quality processes of care related to AKI prevention, identification, and management after major surgery. Design: A three stage modified Delphi process. Setting: The study was conducted in Alberta, Canada using an online format. Participants: A panel of care providers from surgery, critical care, and nephrology. Measurements: The degree of validity of candidate indicators were rated by panelists on a 7-point Likert scale that ranged from “strongly disagree” to “strongly agree”. Methods: A focused literature review was performed to identify candidate indicators. A modified Delphi process, with three rounds, was used to obtain expert consensus on the validity of potential process of care quality indicators. Results: Thirty-three physicians participated (6 from surgery, 10 from critical care, and 17 from nephrology). A list of 58 potential process of care quality indicators for AKI after surgery was generated including 28 indicators from the initial literature review and 30 indicators suggested by panelists. Following the third round of questioning, 40 process of care indicators were identified with a high level of agreement for face validity; 16 of these reached high consensus among all panelists. Limitations: The consensus of panelists from Alberta, Canada may not be generalizable to other settings. The modified Delphi process did not focus on the feasibility of measuring these process indicators. Conclusions: These indicators can be used to measure and improve the quality of care for AKI after major surgery.https://doi.org/10.1186/s40697-015-0047-8 |
| spellingShingle | Matthew T James Neesh Pannu Rebecca Barry Divya Karsanji Marcello Tonelli Brenda R Hemmelgarn Braden J Manns Sean M Bagshaw H Tom Stelfox Elijah Dixon A Modified Delphi Process to Identify Process of Care Indicators for the Identification, Prevention and Management of Acute Kidney Injury after Major Surgery Canadian Journal of Kidney Health and Disease |
| title | A Modified Delphi Process to Identify Process of Care Indicators for the Identification, Prevention and Management of Acute Kidney Injury after Major Surgery |
| title_full | A Modified Delphi Process to Identify Process of Care Indicators for the Identification, Prevention and Management of Acute Kidney Injury after Major Surgery |
| title_fullStr | A Modified Delphi Process to Identify Process of Care Indicators for the Identification, Prevention and Management of Acute Kidney Injury after Major Surgery |
| title_full_unstemmed | A Modified Delphi Process to Identify Process of Care Indicators for the Identification, Prevention and Management of Acute Kidney Injury after Major Surgery |
| title_short | A Modified Delphi Process to Identify Process of Care Indicators for the Identification, Prevention and Management of Acute Kidney Injury after Major Surgery |
| title_sort | modified delphi process to identify process of care indicators for the identification prevention and management of acute kidney injury after major surgery |
| url | https://doi.org/10.1186/s40697-015-0047-8 |
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