Development of a Quality Indicator Set for the Optimal Acute Management of Moderate to Severe Traumatic Brain Injury in the Australian Context

  1. Toby Jeffcote
  2. Camila R. Battistuzzo
  3. Rebecca Roach
  4. Catherine Bell
  5. Cino Bendinelli
  6. Stephen Rashford
  7. Ron Jithoo
  8. Belinda J. Gabbe
  9. Oliver Flower
  10. Gerard O’Reilly
  11. Lewis T. Campbell
  12. D. James Cooper
  13. Zsolt J. Balogh
  14. Andrew A. Udy
  15. Delphi panel
  16. Andrew Chow
  17. Anthony Delaney
  18. Andrew Hooper
  19. Aniket Nadkarni
  20. Amber-Louise J. Poulter
  21. Adam Wells
  22. Benjamin Reddi
  23. Biswadev Mitra
  24. Brad Sheridan
  25. Brian Burns
  26. Carly Rienecker
  27. Daniel Bodnar
  28. David Bowen
  29. Dashiell Gantner
  30. Fatima Nasrallah
  31. Geoffrey Healy
  32. Gleen Ryan
  33. James R. Anstey
  34. Jeremy Hsu
  35. Judith Bellapart
  36. Kate King
  37. Kelly Harbour
  38. Rosalind L. Jeffree
  39. Shailesh Bihari
  40. Melinda Fitzgerald
  41. Michael Noonan
  42. Mark Plummer
  43. Michael C. Reade
  44. Michaela Waak
  45. Mark Weeden
  46. Paul David Cooper
  47. Peter Cameron
  48. Rinaldo Bellomo
  49. Robert McNamara
  50. Stephen McGloughlin
  51. Terence J. O’Brien
  52. Teresa Withers
  53. Torg Westerlund
Read the full article See related articles

Listed in

This article is not in any list yet, why not save it to one of your lists.
Log in to save this article

Abstract

Background

The aim of this study was to develop a consensus-based set of indicators of high-quality acute moderate to severe traumatic brain injury (msTBI) clinical management that can be used to measure structure, process, and outcome factors that are likely to influence patient outcomes. This is the first stage of the PRECISION-TBI program, which is a prospective cohort study that aims to identify and promote optimal clinical management of msTBI in Australia.

Methods

A preliminary set of 45 quality indicators was developed based on available evidence. An advisory committee of established experts in the field refined the initial indicator set in terms of content coverage, proportional representation, contamination, and supporting evidence. The refined indicator set was then distributed to a wider Delphi panel for assessment of each indicator in terms of validity, measurement feasibility, variability, and action feasibility. Inclusion in the final indicator set was contingent on prespecified inclusion scoring.

Results

The indicator set was structured according to the care pathway of msTBI and included prehospital, emergency department, neurosurgical, intensive care, and rehabilitation indicators. Measurement domains included structure indicators, logistic indicators, and clinical management indicators. The Delphi panel consisted of 44 participants (84% physician, 12% nursing, and 4% primary research) with a median of 15 years of practice. Of the 47 indicators included in the second round of the Delphi, 32 indicators were approved by the Delphi group.

Conclusions

This study identified a set of 32 quality indicators that can be used to structure data collection to drive quality improvement in the clinical management of msTBI. They will also be used to guide feedback to PRECISION-TBI’s participating sites.

Article activity feed

  1. Version published to 10.1007/s12028-024-02107-x
  2. Version published to 10.21203/rs.3.rs-4608646/v1 on Research Square