Resident-Sensitive Quality Measures in the Pediatric Emergency Department: Exploring Relationships With Supervisor Entrustment and Patient Acuity and Complexity
This study explores the associations between resident-sensitive quality measures (RSQMs) and supervisor entrustment as well as between RSQMs and patient acuity and complexity for encounters in the pediatric emergency department (PED) in which residents are caring for patients. Method Pediatric residents rotating through Cincinnati Children’s Hospital Medical Center PED as well as supervising pediatric emergency medicine faculty and fellows were recruited during the 2017–2018 academic year for the purpose of collecting the following data from the residents’ patient encounters for 3 illnesses (acute asthma exacerbation, bronchiolitis, and closed head injury [CHI]): supervisor entrustment decision rating, RSQMs relevant to the care provided, and supervisor patient acuity and complexity ratings. To measure the association of RSQM composite scores with the other variables of interest, mixed models were used. Results A total of 83 residents cared for 110 patients with asthma, 112 with bronchiolitis, and 77 with CHI. Entrustment decision ratings were positively associated with asthma RSQM composite scores (beta coefficient = 0.03; P
Publication date: October 2020Source: Brain, Behavior, and Immunity, Volume 89Author(s): Xiaoqin Liu, Trine Munk-Olsen, Clara Albiñana, Bjarni J. Vilhjálmsson, Emil M. Pedersen, Vivi Schlünssen, Marie Bækvad-Hansen, Jonas Bybjerg-Grauholm, Merete Nordentoft, Anders D. Børglum, Thomas Werge, David M. Hougaard, Preben B. Mortensen, Esben Agerbo
Publication date: Available online 9 October 2020Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Manuel Jorge Rial, Marcela Valverde, Victoria del Pozo, Francisco Javier González-Barcala, Carlos Martínez-Rivera, Xavier Muñoz, José María Olaguibel, Vicente Plaza, Elena Curto, Santiago Quirce, Pilar Barranco, Javier Domínguez-Ortega, Joaquin Mullol, César Picado, Antonio Valero, Irina Bobolea, Ebymar Arismendi, Paula Ribó, Joaquín Sastre
Purpose of Study: Explore the perceptions of primary care physicians (PCPs) from community health care centers (CHCs) in Franklin County, Ohio, regarding factors that contribute to their inability to consistently provide sustainable asthma management services to their uninsured patient population. Primary Practice Setting: Asthmatic patients are not consistently receiving sustainable asthma management in CHCs in Ohio. Primary care physicians in CHCs play a pivotal role in closing health care gaps for asthmatic patients. To minimize the barriers that impede the efforts of PCPs to control asthma for their uninsured pati...
Publication date: Available online 9 October 2020Source: Pulmonary Pharmacology &TherapeuticsAuthor(s): Osamu Matsuno, Seijiro Minamoto
Conclusions Individually and collectively, RSQMs can distinguish variations in the tasks residents perform across patient encounters.
Publication date: Available online 27 June 2019Source: Annals of Emergency MedicineAuthor(s): Keith E. Kocher, Rajan Arora, Benjamin S. Bassin, Lee S. Benjamin, Michaelina Bolton, Blaine J. Dennis, Jason J. Ham, Seth S. Krupp, Kelly A. Levasseur, Michelle L. Macy, Brian J. O’Neil, James M. Pribble, Robert L. Sherwin, Nicole S. Sroufe, Bradley J. Uren, Michele M. NypaverStudy objectiveLarge-scale quality and performance measurement across unaffiliated hospitals is an important strategy to drive practice change. The Michigan Emergency Department Improvement Collaborative (MEDIC), established in 2015, has baseline perfo...
ConclusionsThis study continues to pave the path forward in developing future RSQMs by exploring specific settings, measures, and stakeholders to consider when undertaking this work.
This study engaged resident and supervisor stakeholders to develop and inform next steps in creating such measures.MethodsTwo separate nominal group techniques (NGT), one with residents and one with faculty and fellow supervisors, were used to generate RSQMs for three specific illnesses (asthma, bronchiolitis, closed head injury) as well as general care for the pediatric emergency department (PED). Two separate Delphi processes were then used to prioritize identified RSQMs. The measures produced by each group were compared side-by-side, illuminating similarities and differences that were explored through focus groups with ...
Conclusions This study describes a template for identifying and developing RSQMs that may promote high-quality care delivery during and following training. Next steps should include implementing and seeking validity evidence for the locally developed measures.
Conclusions Findings from this study provide a better understanding of what should be communicated to caregivers of children who present to the ED with a number of different illness presentations. Results from this study suggest that health care providers agree on the importance of providing information to caregivers regarding when to return to the ED with their child. Reaching consensus among all experts in this study provides insight into the difficulty of standardizing discharge communication in the absence of widely accepted guidelines.