Validation of New Quality Measures for Transitions Between Sites of Care
Validation of New Quality Measures for Transitions Between Sites of Care
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DOI：
10.1542/peds.2016-4178
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发表时间：
2017-05-01
期刊：
影响因子：
8
通讯作者：
Mangione-Smith, Rita
中科院分区：
文献类型：
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作者：
Parast, Layla;Burkhart, Q.;Mangione-Smith, Rita
背景和目的：评估和提高从急诊科（ED）或医院转回家的质量对患者安全至关重要。我们的目的是验证8项新开发的护理人员报告的过渡质量测量。方法：这项前瞻性观察性研究纳入了2014年在西雅图儿童医院就诊（n = 523）或住院（n = 563）的1086名护理人员调查对象。联系护理人员完成2项调查。第一次调查包括新开发的过渡质量措施和多种验证措施，包括修改版本的儿童医院消费者对医疗保健提供者和系统的评估（HCAHPS）复合材料，评估沟通和出院计划。第二次调查（30天后进行）包括关于随访预约、急诊科复诊和再入院的问题。使用多元回归，我们检查了新开发的过渡质量度量和每个验证度量之间的关联。结果：所有过渡质量指标均与>= 1验证指标显著相关。评估出院指示是否容易理解、有用和包含必要的随访信息的从医院到家的过渡措施与儿童HCAHPS护士-父母和医生-父母沟通复合材料的关联最大（beta = 55.6, 95%置信区间为43至68.3；和beta= 48.3, 95%置信区间分别为36.3至60.3，缩放以反映与过渡措施得分0至100变化相关的变化）。结论：新开发的儿科急诊科和医院到家庭过渡的质量测量与先前验证的护理人员体验测量显着正相关。这些新措施可能有助于评估和提高急诊科和医院到家庭过渡的质量。
BACKGROUND AND OBJECTIVE: Assessing and improving the quality of transitions to home from the emergency department (ED) or hospital is critical for patient safety. Our objective was to validate 8 newly developed caregiver-reported measures of transition quality.METHODS: This prospective observational study included 1086 caregiver survey respondents whose children had an ED visit (n = 523) or hospitalization (n = 563) at Seattle Children's Hospital in 2014. Caregivers were contacted to complete 2 surveys. The first survey included the newly developed transition quality measures and multiple validation measures including modified versions of Child Hospital Consumer Assessments of Healthcare Providers and Systems (HCAHPS) composites, assessing communication and discharge planning. The second survey (administered 30 days later) included questions about follow-up appointments and ED return visits and readmissions. Using multivariate regression, we examined associations between the newly developed transition quality measures and each validation measure.RESULTS: All transition quality measures were significantly associated with >= 1 validation measures. The hospital-to-home transition measure assessing whether discharge instructions were easy to understand, were useful, and contained necessary follow-up information had the largest association with the Child HCAHPS nurse-parent and doctor parent communication composites (beta = 55.6; 95% confidence interval, 43 to 68.3; and beta= 48.3; 95% confidence interval, 36.3 to 60.3, respectively, scaled to reflect change associated with a 0 to 100 change in the transition measure score).CONCLUSIONS Newly developed quality measures for pediatric ED- and hospital-to-home transitions were significantly and positively associated with previously validated measures of caregiver experience. These new measures may be useful for assessing and improving on the quality of ED- and hospital-to-home transitions.