Establishing gold standards for System-Level Measures: a modified Delphi consensus process.

OBJECTIVE

To establish aspirational 'gold standards' for a suite of System-Level Measures (SLMs) being used by Counties Manukau Health (CM Health), a New Zealand (NZ) District Health Board.

DESIGN

This study employed a multi-stage, multi-method modified Delphi consensus process.

SETTING

The Delphi consensus process involved virtual (email) communication between participants (Round 1) and a structured face-to-face meeting (Round 2) held in Auckland, NZ.

PARTICIPANTS

Participants comprised of health professionals, managers, academics and quality improvement experts with an interest in the use of SLMs.

INTERVENTIONS

Participants in the first round received a letter requesting their participation in an anonymous Delphi. The second round involved national and international health system experts taking part in a structured, facilitated face-to-face meeting. Participants reviewed 15 SLMs in total. The SLMs all related to the three domains of the Triple Aim: Population Health, e.g. life expectancy at birth; Patient Experience of Care, e.g. rate of adverse events; and Cost and Productivity, e.g. healthcare expenditure per capita.

MAIN OUTCOME MEASURES

For a proposed gold standard to be agreed and established for each SLM.

RESULTS

Twelve participants took part in Round 1, with 19 participating in Round 2. The process established agreement on a gold standard for each of the 15 reviewed SLMs.

CONCLUSION

We demonstrated that the Delphi consensus process can be used to establish gold standards for a suite of SLMs used by a NZ Health Board (CM Health).