Evidence map›Paper›PMID 30642263›Full record

ArticleBMC emergency medicine2019

Developing outcome, process and balancing measures for an emergency department longitudinal patient monitoring system using a modified Delphi.

Marie E Ward, Abel Wakai, Ronald McDowell, Fiona Boland, Eoin Coughlan, Moayed Hamza, John Browne, Ronan O'Sullivan, Una Geary, Fiona McDaid and 4 more

Abstract read
In one paragraph

Article in BMC emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Marie E WardSchool of Nursing, Midwifery and Health Systems, C129, UCD Health Sciences Centre, University College Dublin, Belfield, Dublin, 4, Ireland.
Abel WakaiEmergency Care Research Unit (ECRU), Division of Population Health Sciences (PHS), Royal College of Surgeons in Ireland (RCSI), Dublin 2 and Department of Emergency Medicine, Beaumont Hospital, Dublin, 9, Ireland.
Ronald McDowellGeneral Practice and HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, BT126BA, UK.
Fiona BolandDivision of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
Eoin CoughlanDepartment of Epidemiology and Public Health, University College Cork, Western Rd, Cork, Ireland.
Moayed HamzaSchool of Nursing, Midwifery and Health Systems, C129, UCD Health Sciences Centre, University College Dublin, Belfield, Dublin, 4, Ireland.
John BrowneDepartment of Epidemiology and Public Health, University College Cork, Western Rd, Cork, Ireland.
Ronan O'SullivanBon Secours Hospital, Cork, Ireland.
Una GearyDepartment of Emergency Medicine, St James's Hospital, Dublin, 8, Ireland.
Fiona McDaidDepartment of Emergency Medicine, Naas Hospital, Naas, Co, Kildare, Ireland.
Éidín Ní ShéSchool of Nursing, Midwifery and Health Systems, C129, UCD Health Sciences Centre, University College Dublin, Belfield, Dublin, 4, Ireland.
Frances J DrummondCancer Research@UCC, University College Cork, Cork, Ireland.
Conor DeasyDepartment of Emergency Medicine, Cork University Hospital, Cork, Ireland.
Eilish McAuliffeSchool of Nursing, Midwifery and Health Systems, C129, UCD Health Sciences Centre, University College Dublin, Belfield, Dublin, 4, Ireland. Eilish.mcauliffe@ucd.ie.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly warning score systems have been widely recommended for use to detect clinical deterioration in patients. The Irish National Emergency Medicine Programme has developed and piloted an emergency department specific early warning score system. The objective of this study was to develop a consensus among frontline healthcare staff, quality and safety staff and health systems researchers regarding evaluation measures for an early warning score system in the Emergency Department.

methodsParticipatory action research including a modified Delphi consensus building technique with frontline hospital staff, quality and safety staff, health systems researchers, local and national emergency medicine stakeholders was the method employed in this study. In Stage One, a workshop was held with the participatory action research team including frontline hospital staff, quality and safety staff and health systems researchers to gather suggestions regarding the evaluation measures. In Stage Two, an electronic modified-Delphi study was undertaken with a panel consisting of the workshop participants, key local and national emergency medicine stakeholders. Descriptive statistics were used to summarise the characteristics of the panellists who completed the questionnaires in each round. The mean Likert rating, standard deviation and 95% bias-corrected bootstrapped confidence interval for each variable was calculated. Bonferroni corrections were applied to take account of multiple testing. Data were analysed using Stata 14.0 SE.

resultsUsing the Institute for Healthcare Improvement framework, 12 process, outcome and balancing metrics for measuring the effectiveness of an ED-specific early warning score system were developed.

conclusionThere are currently no published measures for evaluating the effectiveness of an ED early warning score system. It was possible in this study to develop a suite of evaluation measures using a modified Delphi consensus approach. Using the collective expertise of frontline hospital staff, quality and safety staff and health systems researchers to develop and categorise the initial set of potential measures was an innovative and unique element of this study.

Indexed as

Monitoring, PhysiologicQuality Indicators, Health CareConsensusDelivery of Health CareDelphi TechniqueDisease ProgressionEmergency Service, HospitalHumansOutcome and Process Assessment, Health CareEarly warning score systemEmergency departmentEvaluation measuresLongitudinal patient monitoring

Identifiers

PMID30642263
PMCPMC6332627

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.