Development of quality indicators for departments of hospital-based physiotherapy: a modified Delphi study

Abstract

BackgroundInternational hospital accreditation instruments, such as Joint Commission International (JCI) and Qmentum, focus mainly on hospital policy and procedures and do not specifically cover a profession such as hospital-based physiotherapy. This justifies the need for a quality system to which hospital-based physiotherapy can better identify, based on a common framework of quality indicators for effective quality management.ObjectiveThis study aimed to identify the most important quality indicators of a hospital-based physiotherapy department in the eyes of hospital-based physiotherapists and their managers.MethodsBased on input from three focus groups and a structured literature review, a first set of quality indicators for hospital physiotherapy was assembled. After checking this set for duplicates and for overlap with JCI and Qmentum, it formed the starting point of a modified Delphi procedure. In two rounds, 17 hospital-based physiotherapy experts rated the quality indicators on relevance through online surveys. In a final consensus meeting, quality indicators were established, classified in quality themes and operationalised by describing for each theme the rationale, specifications, domain and type of indicator.ResultsThree focus groups provided 120 potential indicators, which were complemented with 18 potential indicators based on literature. After duplicate and overlap check and the Delphi procedure, these 138 potential indicators were reduced to a set of 56 quality indicators for hospital-based physiotherapy. Finally, these 56 indicators were condensed into 7 composite indicators, each representing a quality theme based on definitions of the European Foundation for Quality Management.ConclusionA set of 56 quality indicators, condensed into 7 composite indicators each representing a quality theme, was developed to assess the quality of a hospital-based physiotherapy department.

Defining adverse events during trauma resuscitation: a modified RAND Delphi study

“…Additionally, a recording of the consensus meeting was sent to all participants for final review and to elicit any additional feedback. Although Delphi consensus groups can produce collective answers, the achieved consensus is not necessarily valid 18 19. Still, they can identify areas of focus for future research, which is especially true for our study on AEs in trauma.…”

“…Additionally, as the consensus meeting was not anonymous, participants may have felt hesitant to speak freely or bias may have been introduced by one individual’s opinion being over-represented. 18 The study team attempted to mitigate this by including a chat function during the consensus call so that all Delphi members were able to comment throughout the meeting. Additionally, a recording of the consensus meeting was sent to all participants for final review and to elicit any additional feedback.…”

“…Although Delphi consensus groups can produce collective answers, the achieved consensus is not necessarily valid. 18 19 Still, they can identify areas of focus for future research, which is especially true for our study on AEs in trauma. Future research could focus on establishing the validity and reliability of measuring the taxonomy of AEs and degree of harm system proposed in this study, with further refinement of definitions and terms to improve the accuracy of measuring these AEs.…”

“…The expert panel consisted of a majority of physicians (rather than non-physician clinicians) which may have influenced ratings. Additionally, as the consensus meeting was not anonymous, participants may have felt hesitant to speak freely or bias may have been introduced by one individual’s opinion being over-represented 18. The study team attempted to mitigate this by including a chat function during the consensus call so that all Delphi members were able to comment throughout the meeting.…”

Application of the defect management improvement mode under Joint Commission International standard to improve the instrument cleaning and disinfection effect and management quality in the central sterile supply department: a randomized trial

“…The vice president, as the supervisor CSSD director, is the first responsible person, and each connecting department shall supervise and inspect and jointly complete the rectification work. This management mode is conducive to establish JCI awareness among staff, correctly understanding errors, optimizing the process, as well as analyzing the root causes, identifying defects, and formulating targeted solutions, so as to effectively prevent errors and improve the qualification rate of each operation process (15,16). In daily work, the "five regular methods" can be used to manage and maintain the working environment (17), this will ensure a sustainable improvement in the quality of CSSD instruments and equipment, and improve the professional ability and service level of the team.…”