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Formal selection of measures for a composite index of NICU quality of care: Baby-MONITOR.

CPQCC Publication
TitleFormal selection of measures for a composite index of NICU quality of care: Baby-MONITOR.
Publication TypeJournal Article
Year of Publication2011
AuthorsProfit J, Gould JB, Zupancic JAF, Stark AR, Wall KM, Kowalkowski MA, Mei M, Pietz K, Thomas EJ, Petersen LA
JournalJ Perinatol
Date Published2011 Nov
KeywordsData Collection, Delphi Technique, Humans, Infant, Newborn, Infant, Very Low Birth Weight, Intensive Care Units, Neonatal, Quality Assurance, Health Care, Quality of Health Care

OBJECTIVE: To systematically rate measures of care quality for very low birth weight infants for inclusion into Baby-MONITOR, a composite indicator of quality.

STUDY DESIGN: Modified Delphi expert panelist process including electronic surveys and telephone conferences. Panelists considered 28 standard neonatal intensive care unit (NICU) quality measures and rated each on a 9-point scale taking into account pre-defined measure characteristics. In addition, panelists grouped measures into six domains of quality. We selected measures by testing for rater agreement using an accepted method.

RESULT: Of 28 measures considered, 13 had median ratings in the high range (7 to 9). Of these, 9 met the criteria for inclusion in the composite: antenatal steroids (median (interquartile range)) 9(0), timely retinopathy of prematurity exam 9(0), late onset sepsis 9(1), hypothermia on admission 8(1), pneumothorax 8(2), growth velocity 8(2), oxygen at 36 weeks postmenstrual age 7(2), any human milk feeding at discharge 7(2) and in-hospital mortality 7(2). Among the measures selected for the composite, the domains of quality most frequently represented included effectiveness (40%) and safety (30%).

CONCLUSION: A panel of experts selected 9 of 28 routinely reported quality measures for inclusion in a composite indicator. Panelists also set an agenda for future research to close knowledge gaps for quality measures not selected for the Baby-MONITOR.

Alternate JournalJ Perinatol
PubMed ID21350429
PubMed Central IDPMC3205234
Grant ListK23 HD056298 / HD / NICHD NIH HHS / United States
K23 HD056298-04 / HD / NICHD NIH HHS / United States
K24 HD053771 / HD / NICHD NIH HHS / United States
K23 HD056298-01 / HD / NICHD NIH HHS / United States