Madsen Michael Moesmann, Eiset Andreas Halgreen, Mackenhauer Julie, Odby Annette, Christiansen Christian Fynbo, Kurland Lisa, Kirkegaard Hans
Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Research Center for Emergency Medicine, University of Aarhus, Aarhus, Denmark.
Scand J Trauma Resusc Emerg Med. 2016 Feb 3;24:11. doi: 10.1186/s13049-016-0203-x.
In 2013, Danish policy-makers on a nationwide level decided to set up a national quality of care database for hospital-based emergency care in Denmark including the selection of quality indicators. The aim of the study was to describe the Delphi process that contributed to the selection of quality indicators for a new national database of hospital-based emergency care in Denmark.
The process comprised a literature review followed by a modified-Delphi survey process, involving a panel of 54 experts (senior clinicians, researchers and administrators from the emergency area and collaborating specialties). Based on the literature review, we identified 43 potential indicators, of which eight were time-critical conditions. We then consulted the Expert panel in two consecutive rounds. The Expert panel was asked to what extent each indicator would be a good measure of hospital-based emergency care in Denmark. In each round, the Expert panel participants scored each indicator on a Likert scale ranging from one (=disagree completely) through to six (=agree completely). Consensus for a quality indicator was reached if the median was greater than or equal to five (=agree). The Delphi process was followed by final selection by the steering group for the new database.
Following round two of the Expert panel, consensus was reached on 32 quality indicators, including three time-critical conditions. Subsequently, the database steering group chose a set of nine quality indicators for the initial version of the national database for hospital-based emergency care.
The two-round modified Delphi process contributed to the selection of an initial set of nine quality indicators for a new a national database for hospital-based emergency care in Denmark. Final selection was made by the database steering group informed by the Delphi process.
2013年，丹麦政策制定者在全国范围内决定建立一个丹麦医院急诊护理全国质量数据库，包括质量指标的选择。本研究的目的是描述有助于为丹麦新的医院急诊护理全国数据库选择质量指标的德尔菲过程。
该过程包括文献综述，随后是改良德尔菲调查过程，涉及一个由54名专家组成的小组（来自急诊领域及相关专业的资深临床医生、研究人员和管理人员）。基于文献综述，我们确定了43个潜在指标，其中8个是时间关键型病症。然后我们连续两轮咨询专家小组。要求专家小组评估每个指标在多大程度上可作为丹麦医院急诊护理的良好衡量标准。在每一轮中，专家小组参与者根据从1（=完全不同意）到6（=完全同意）的李克特量表对每个指标进行评分。如果中位数大于或等于5（=同意），则达成质量指标的共识。德尔菲过程之后由新数据库的指导小组进行最终选择。
在专家小组第二轮之后，就32个质量指标达成了共识，包括3个时间关键型病症。随后，数据库指导小组为医院急诊护理全国数据库的初始版本选择了一组9个质量指标。
两轮改良德尔菲过程有助于为丹麦新的医院急诊护理全国数据库选择一组初始的9个质量指标。最终选择由数据库指导小组在德尔菲过程的基础上做出。
