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Quality measurement and surveillance platforms in critically ill children: A scoping review

  • Jessica A. Schults
    Correspondence
    Corresponding author at: Centre for Clinical Research, University of Queensland, Rm 318 Herston Campus, Queensland 4006, Australia. Tel: +61 (0)733466077.
    Affiliations
    School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland, Australia

    Metro North Hospital and Health Service, Queensland, Australia

    Child Health Research Centre, Faculty of Medicine, University of Queensland, St Lucia, Queensland, Australia

    School of Nursing and Midwifery Griffith University, Queensland, Australia

    Paediatric Intensive Care Unit Queensland Children's Hospital, South Brisbane, Queensland, Australia
    Search for articles by this author
  • Claire M. Rickard
    Affiliations
    School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland, Australia

    Metro North Hospital and Health Service, Queensland, Australia

    School of Nursing and Midwifery Griffith University, Queensland, Australia
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  • Karina Charles
    Affiliations
    School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland, Australia

    Child Health Research Centre, Faculty of Medicine, University of Queensland, St Lucia, Queensland, Australia

    School of Nursing and Midwifery Griffith University, Queensland, Australia

    Paediatric Intensive Care Unit Queensland Children's Hospital, South Brisbane, Queensland, Australia
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  • Sarfaraz Rahiman
    Affiliations
    Paediatric Intensive Care Unit Queensland Children's Hospital, South Brisbane, Queensland, Australia

    School of Medicine, University of Queensland, St Lucia, Queensland, Australia
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  • Johnny Millar
    Affiliations
    Paediatric Intensive Care Unit, Royal Children's Hospital, Melbourne, Victoria, Australia

    Murdoch Children's Research Institute, Victoria, Australia

    Department of Paediatrics, University of Melbourne, Victoria, Australia

    Centre for Outcome and Resource Evaluation, Australian and New Zealand Intensive Care Society, Melbourne, Australia
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  • Thimitra Baveas
    Affiliations
    Paediatric Intensive Care Unit Queensland Children's Hospital, South Brisbane, Queensland, Australia
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  • Debbie Long
    Affiliations
    Paediatric Intensive Care Unit Queensland Children's Hospital, South Brisbane, Queensland, Australia

    School of Nursing, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
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  • Tricia M. Kleidon
    Affiliations
    School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland, Australia

    School of Nursing and Midwifery Griffith University, Queensland, Australia

    Department of Anaesthesia and Pain Management, Queensland Children's Hospital, South Brisbane, Queensland, Australia
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  • Fiona Macfarlane
    Affiliations
    Department of Anaesthesia and Pain Management, Queensland Children's Hospital, South Brisbane, Queensland, Australia
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  • Nilesh M. Mehta
    Affiliations
    Perioperative & Critical Care Center for Outcomes Research (PC-CORE), USA

    Department of Anesthesiology, Critical Care & Pain Medicine, Division of Critical Care Medicine, Boston Children's Hospital, USA

    Harvard Medical School, Boston, USA
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  • Naomi Runnegar
    Affiliations
    School of Medicine, University of Queensland, St Lucia, Queensland, Australia

    Infection Management, Princess Alexandra Hospital, Woolloongabba, Qld, Australia
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  • Lisa Hall
    Affiliations
    School of Public Health, Faculty of Medicine, University of Queensland, St Lucia, Queensland, Australia
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Published:September 15, 2022DOI:https://doi.org/10.1016/j.aucc.2022.07.006

      Abstract

      Background/aim

      The objective of this study was to describe current surveillance platforms which support routine quality measurement in paediatric critical care.

      Method

      Scoping review. The search strategy consisted of a traditional database and grey literature search as well as expert consultation. Surveillance platforms were eligible for inclusion if they collected measures of quality in critically ill children.

      Results

      The search strategy identified 21 surveillance platforms, collecting 57 unique outcome (70%), process (23%), and structural (7%) quality measures. Hospital-associated infections were the most commonly collected outcome measure across all platforms (n = 11; 52%). In general, case definitions were not harmonised across platforms, with the exception of nationally mandated hospital-associated infections (e.g., central line–associated blood stream infection). Data collection relied on manual coding. Platforms typically did not provide an evidence-based rationale for measures collected, with no identifiable reports of co-designed, consensus-derived measures or consumer involvement in measure selection or prioritisation.

      Conclusions

      Quality measurement in critically ill children lacks uniformity in definition which limits local and international benchmarking. Current surveillance activities for critically ill children focus heavily on outcome measurement, with process, structural, and patient-reported measures largely overlooked. Long-term outcome measures were not routinely collected. Harmonisation of paediatric intensive care unit quality measures is needed and can be achieved using prioritisation and consensus/co-design methods.

      Keywords

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