Degree of compliance with health care quality criteria in the treatment of lower airway obstruction in Spanish pediatric emergency departments, reasons for noncompliance, and recommendations for improvement
Claret Teruel G, Solé Ribalta A, González Balenciaga M, Paniagua Calzón NM, Korta Murua J
Affiliation of the authors
Servicio de Urgencias, Hospital Sant Joan de Déu, Barcelona, Spain. Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Spain. Servicio de Urgencias, Hospital Universitario Cruces, Bilbao, Spain. Biocruces, Instituto de Investigación Sanitaria, Spain. Sección de Neumología Infantil, Hospital Universitario Donostia, San Sebastián, Spain. Departamento de Pediatría, Universidad del País Vasco VPV/EHV, Servicio de Urgencias, Hospital Sant Joan de Déu, Barcelona, Spain. Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Spain. Servicio de Urgencias, Hospital Universitario Cruces, Bilbao, Spain. Biocruces, Instituto de Investigación Sanitaria, Spain. Sección de Neumología Infantil, Hospital Universitario Donostia, San Sebastián, Servicio de Urgencias, Hospital Sant Joan de Déu, Barcelona, Spain. Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Spain. Servicio de Urgencias, Hospital Universitario Cruces, Bilbao, Spain. Biocruces, Instituto de Investigación Sanitaria, Spain. Sección de Neumología Infantil, Hospital Universitario Donostia, San Sebastián, Spain. Departamento de Pediatría, Universidad del País Vasco VPV/EHV, Spain. Departamento de Pediatría, Universidad del País Vasco VPV/EHV, Spain.
Claret Teruel G, Solé Ribalta A, González Balenciaga M, Paniagua Calzón NM, Korta Murua J. Degree of compliance with health care quality criteria in the treatment of lower airway obstruction in Spanish pediatric emergency departments, reasons for noncompliance, and recommendations for improvement. Emergencias. 2016;28:167-72
To determine the degree of compliance with health care quality criteria in the treatment of patients with lower airway obstruction in Spanish pediatric emergency departments (PEDs), to explore the reasons for noncompliance, and to make recommendations for improvement.
Methods.
We carried out a retrospective, cross-sectional study of a series of patients under the age of 14 years to determine the degree of compliance with 5 quality indicators. The patients were attended in 22 PEDs on days 1 and 15 of each month in 2013. We also distributed a questionnaire to chiefs of department to discover possible reasons for
noncompliance. Finally, a group of experts followed a process to produce consensus-based recommendations to improve quality of care through compliance with the indicators.
Results.
We included 2935 patients with a median (interquartile range) age of 2.8 (1.4–5.1) years. The overall rates of compliance were 39.8% for assessment of severity, 0.1% for measurement of peak flow, 64.4% for delay in attending a patient with severe shortness of breath, 59.1% for checking oxygen saturation and respiratory frequency, and 34.3% for
treatment with inhalers and a spacer. The most common reasons for noncompliance were lack of time or material and the absence of the recommendation in protocols. The following improvement steps were recommended: reassess the usefulness of peak flow measurement in PEDs, reformulate the criteria for delay in attending patients with severe dyspnea, and adopt new indicators and templates that facilitate the recording of vital constants and scores on severity scales.
Conclusions.
An acceptable level of compliance was not achieved on any of the health care quality indicators for a variety of reasons. A series of steps should be taken to improve compliance.
This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.
Strictly Necessary Cookies
Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings.
If you disable this cookie, we will not be able to save your preferences. This means that every time you visit this website you will need to enable or disable cookies again.