Observational Study

. 2018 Jun;53(3):1316-1334.

doi: 10.1111/1475-6773.12800. Epub 2017 Nov 16.

Implicit Review Instrument to Evaluate Quality of Care Delivered by Physicians to Children in Emergency Departments

James P Marcin¹, Patrick S Romano^{1

2}, Madan Dharmar¹, James M Chamberlain³, Nanette Dudley⁴, Charles G Macias⁵, Lise E Nigrovic⁶, Elizabeth C Powell⁷, Alexander J Rogers⁸, Meridith Sonnett⁹, Leah Tzimenatos¹⁰, Elizabeth R Alpern¹¹, Rebecca Andrews-Dickert¹², Dominic A Borgialli¹³, Erika Sidney¹⁴, Charlie Casper¹⁵, Jonathan Michael Dean¹⁵, Nathan Kuppermann^{1

10}; Pediatric Emergency Care Applied Research Network

Collaborators, Affiliations

Collaborators

Pediatric Emergency Care Applied Research Network:
J Callahan, P Dayan, M Gerardi, M Gorelick, J Hoyle, E Jacobs, D Jaffe, R Lichenstein, K Lillis, P Mahajan, R Maio, F Moler, D Monroe, R Ruddy, R Stanley, M Tunik, A Walker, D Kavanaugh, H Park, R Holubkov, S Knight, A Donaldson, S Zuspan, M Miskin, J Wade, A Jones, M Fjelstad, T Singh, A Drongowski, L Fukushima, E Kim, G O'Gara, H Rincon, K Brown, L Babcock, G Foltin, S Teach, A Cooper, N C Mann, K Shaw, P Ehrlich, R Enriquez, B Millar, M Shults, W Schalick, S Atabaki, J Burr, K Call, J Suhajda, N Schamban

Affiliations

¹ Department of Pediatrics, University of California, Davis School of Medicine, Sacramento, CA.
² Department of Internal Medicine, University of California, Davis School of Medicine, Sacramento, CA.
³ Division of Emergency Medicine, Children's National Health System, Washington, DC.
⁴ Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.
⁵ Department of Pediatrics and Center for Clinical Effectiveness, Baylor College of Medicine, Houston, TX.
⁶ Division of Emergency Medicine, Boston Children's Hospital, Boston, MA.
⁷ Department of Pediatrics, Northwestern University's Feinberg School of Medicine, Chicago, IL.
⁸ Departments of Emergency Medicine and Pediatrics, University of Michigan, Ann Arbor, MI.
⁹ Department of Pediatrics, Columbia University Medical Center, Columbia University College of Physicians and Surgeons, New York, NY.
¹⁰ Department of Emergency Medicine, University of California, Davis School of Medicine, Sacramento, CA.
¹¹ Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA.
¹² Department of Emergency Medicine, DeVos Children's Hospital, Michigan State University College of Human Medicine, Grand Rapids, MI.
¹³ Department of Emergency Medicine, Hurley Medical Center and University of Michigan, Flint, MI.
¹⁴ Division of Emergency Medicine, Children's Hospital of Colorado, University of Colorado, Aurora, CO.
¹⁵ Department of Pediatrics, University of Utah and PECARN Data Coordinating Center, Salt Lake City, UT.

PMID: 29143331
PMCID: PMC5980311
DOI: 10.1111/1475-6773.12800

Observational Study

Implicit Review Instrument to Evaluate Quality of Care Delivered by Physicians to Children in Emergency Departments

James P Marcin et al. Health Serv Res. 2018 Jun.

. 2018 Jun;53(3):1316-1334.

doi: 10.1111/1475-6773.12800. Epub 2017 Nov 16.

Authors

Collaborators

Pediatric Emergency Care Applied Research Network:
J Callahan, P Dayan, M Gerardi, M Gorelick, J Hoyle, E Jacobs, D Jaffe, R Lichenstein, K Lillis, P Mahajan, R Maio, F Moler, D Monroe, R Ruddy, R Stanley, M Tunik, A Walker, D Kavanaugh, H Park, R Holubkov, S Knight, A Donaldson, S Zuspan, M Miskin, J Wade, A Jones, M Fjelstad, T Singh, A Drongowski, L Fukushima, E Kim, G O'Gara, H Rincon, K Brown, L Babcock, G Foltin, S Teach, A Cooper, N C Mann, K Shaw, P Ehrlich, R Enriquez, B Millar, M Shults, W Schalick, S Atabaki, J Burr, K Call, J Suhajda, N Schamban

Affiliations

¹ Department of Pediatrics, University of California, Davis School of Medicine, Sacramento, CA.
² Department of Internal Medicine, University of California, Davis School of Medicine, Sacramento, CA.
³ Division of Emergency Medicine, Children's National Health System, Washington, DC.
⁴ Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.
⁵ Department of Pediatrics and Center for Clinical Effectiveness, Baylor College of Medicine, Houston, TX.
⁶ Division of Emergency Medicine, Boston Children's Hospital, Boston, MA.
⁷ Department of Pediatrics, Northwestern University's Feinberg School of Medicine, Chicago, IL.
⁸ Departments of Emergency Medicine and Pediatrics, University of Michigan, Ann Arbor, MI.
⁹ Department of Pediatrics, Columbia University Medical Center, Columbia University College of Physicians and Surgeons, New York, NY.
¹⁰ Department of Emergency Medicine, University of California, Davis School of Medicine, Sacramento, CA.
¹¹ Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA.
¹² Department of Emergency Medicine, DeVos Children's Hospital, Michigan State University College of Human Medicine, Grand Rapids, MI.
¹³ Department of Emergency Medicine, Hurley Medical Center and University of Michigan, Flint, MI.
¹⁴ Division of Emergency Medicine, Children's Hospital of Colorado, University of Colorado, Aurora, CO.
¹⁵ Department of Pediatrics, University of Utah and PECARN Data Coordinating Center, Salt Lake City, UT.

PMID: 29143331
PMCID: PMC5980311
DOI: 10.1111/1475-6773.12800

Abstract

Objective: To evaluate the consistency, reliability, and validity of an implicit review instrument that measures the quality of care provided to children in the emergency department (ED).

Data sources/study setting: Medical records of randomly selected children from 12 EDs in the Pediatric Emergency Care Applied Research Network (PECARN).

Study design: Eight pediatric emergency medicine physicians applied the instrument to 620 medical records.

Data collection/extraction methods: We determined internal consistency using Cronbach's alpha and inter-rater reliability using the intraclass correlation coefficient (ICC). We evaluated the validity of the instrument by correlating scores with four condition-specific explicit review instruments.

Principal findings: Individual reviewers' Cronbach's alpha had a mean of 0.85 with a range of 0.76-0.97; overall Cronbach's alpha was 0.90. The ICC was 0.49 for the summary score with a range from 0.40 to 0.46. Correlations between the quality of care score and the four condition-specific explicit review scores ranged from 0.24 to 0.38.

Conclusions: The quality of care instrument demonstrated good internal consistency, moderate inter-rater reliability, high inter-rater agreement, and evidence supporting validity. The instrument could be useful for systems' assessment and research in evaluating the care delivered to children in the ED.

Keywords: Pediatrics; emergency department; quality.

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References

1. Agency for Healthcare Research and Quality . 2014. “National Guideline Clearinghouse” [accessed on June 16, 2014]. Available at http://www.guideline.gov/
1. Alper, J. , Sanders J., Saunders R. S., and Institute of Medicine . 2013. Roundtable on Value and Science‐Driven Health Care. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: National Academies Press. - PubMed
1. Alpern, E. R. , Stanley R. M., Gorelick M. H., Donaldson A., Knight S., Teach S. J., Singh T., Mahajan P., Goepp J. G., Kuppermann N., Dean J. M., and Chamberlain J. M., and Pediatric Emergency Care Applied Research . 2006. “Epidemiology of a Pediatric Emergency Medicine Research Network: The PECARN Core Data Project.” Pediatric Emergency Care 22 (10): 689–99. - PubMed
1. Ashton, C. M. , Kuykendall D. H., Johnson M. L., and Wray N. P.. 1999. “An Empirical Assessment of the Validity of Explicit and Implicit Process‐of‐Care Criteria for Quality Assessment.” Medical Care 37 (8): 798–808. - PubMed
1. Bardach, N. S. , Chien A. T., and Dudley R. A.. 2010. “Small Numbers Limit the Use of the Inpatient Pediatric Quality Indicators for Hospital Comparison.” Academic Pediatrics 10 (4): 266–73. - PMC - PubMed

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Implicit Review Instrument to Evaluate Quality of Care Delivered by Physicians to Children in Emergency Departments

Collaborators

Affiliations

Implicit Review Instrument to Evaluate Quality of Care Delivered by Physicians to Children in Emergency Departments

Authors

Collaborators

Affiliations

Abstract

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical