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Eur J Pediatr Surg
DOI: 10.1055/s-0043-1777100
Original Article

Selection of Quality Indicators to Evaluate Quality of Care for Patients with Esophageal Atresia Using a Delphi Method

Nadine M. Teunissen 
1   EPSA|ERNICA Registry, European Reference Network for Rare Inherited and Congenital Anomalies, Rotterdam, the Netherlands
2   Dutch Institute for Clinical Auditing, Leiden, the Netherlands
3   Department of Pediatric Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
,
Julia Brendel
1   EPSA|ERNICA Registry, European Reference Network for Rare Inherited and Congenital Anomalies, Rotterdam, the Netherlands
4   Department of Pediatric Surgery, Hannover Medical School, Hannover, Niedersachsen, Germany
,
L.W Ernest van Heurn
1   EPSA|ERNICA Registry, European Reference Network for Rare Inherited and Congenital Anomalies, Rotterdam, the Netherlands
5   Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
6   Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
,
Benno Ure
4   Department of Pediatric Surgery, Hannover Medical School, Hannover, Niedersachsen, Germany
,
Rene Wijnen
1   EPSA|ERNICA Registry, European Reference Network for Rare Inherited and Congenital Anomalies, Rotterdam, the Netherlands
3   Department of Pediatric Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
,
Simon Eaton 
1   EPSA|ERNICA Registry, European Reference Network for Rare Inherited and Congenital Anomalies, Rotterdam, the Netherlands
3   Department of Pediatric Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
7   Developmental Biology and Cancer Research and Teaching Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom of Great Britain and Northern Ireland
,
on behalf of the EPSA|ERNICA Registry Group, the EA Quality of Care Initiative › Author Affiliations
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Abstract

Objective Survival of neonates with esophageal atresia (EA) is relatively high and stable, resulting in increased attention to optimizing care and longer-term morbidity. This study aimed to reach consensus on a quality indicator set for benchmarking EA care between hospitals, regions, or countries in a European clinical audit.

Methods Using an online Delphi method, a panel of EA health care professionals and patient representatives rated potential outcome, structure, and process indicators for EA care identified through systematic literature and guideline review on a nine-point Likert scale in three questionnaires. Items were included based on predefined criteria. In rounds 2 and 3, participants were asked to select the five to ten most essential of the included indicators.

Results An international panel of 14 patient representatives and 71 multidisciplinary health care professionals representing 41 European hospitals completed all questionnaires (response rate: 81%), eventually including 22 baseline characteristics and 32 indicators. After ranking, 10 indicators were prioritized by both stakeholder groups. In addition, each stakeholder group highly prioritized one additional indicator. Following an additional online vote by the other group, these were both added to the final set.

Conclusion This study established a core indicator set of twenty-two baseline characteristics, eight outcome indicators, one structure indicator, and three process indicators for evaluating (quality of) EA care in Europe. These indicators, covering various aspects of EA care, will be implemented in the European Pediatric Surgical Audit to enable recognition of practice variation and focus EA care improvement initiatives.

Keywords

esophageal atresia - quality indicators - clinical audit

# See the online Supplementary Appendix for a list of the EPSA|ERNICA Registry Group members and their affiliated hospitals.


* See the online Supplementary Appendix for a list of the EA Quality of Care Initiative members and their affiliated hospitals or organizations.


Supplementary Material



Publication History

Received: 19 May 2023

Accepted: 21 September 2023

Article published online:
12 December 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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