Department of Otolaryngology-Head and Neck Surgery, University of Toronto.
Faculty of Medicine, University of Toronto, Toronto.
Otol Neurotol. 2021 Sep 1;42(8):e991-e1000. doi: 10.1097/MAO.0000000000003205.
Sudden sensorineural hearing loss (SSNHL) is an ideal entity for quality indicator (QI) development, providing treatment challenges resulting in variable or substandard care. The American Academy of Otolaryngology-Head and Neck Surgery recently updated their SSNHL guidelines. With SSNHL demonstrating a large burden of illness, this study sought to leverage the updated guidelines and develop QIs that support quality improvement initiatives at an individual, institutional, and systems level.
Candidate indicators (CIs) were extracted from high-quality SSNHL guidelines that were evaluated using the Appraisal of Guidelines for Research and Evaluation II tool. Each CI and its supporting evidence were summarized and reviewed by a nine-member expert panel based on validity, reliability, and feasibility of measurement. Final QIs were selected from CIs using the modified RAND Corporation-University of California, Los Angeles appropriateness methodology.
Fifteen CIs were identified after literature review. After the first round of evaluations, the panel agreed on 11 candidate indicators as appropriate QIs with 2 additional CIs suggested for consideration. An expert panel meeting provided a platform to discuss areas of disagreement before final evaluations. The expert panel subsequently agreed upon 11 final QIs as appropriate measures of high-quality care for SSNHL.
The 11 proposed QIs from this study are supported by evidence and expert consensus, facilitating measurement across a wide breadth of quality domains. With the recently updated SSNHL guidelines, and a greater focus on quality improvement opportunities, these QIs may be used by healthcare providers for targeted quality improvement initiatives.
突发性聋（SSNHL）是开发质量指标（QI）的理想实体，为治疗带来挑战，导致护理结果存在差异或不达标。美国耳鼻喉科学会最近更新了其 SSNHL 指南。鉴于 SSNHL 疾病负担巨大，本研究旨在利用最新指南，开发支持个体、机构和系统各级质量改进计划的 QI。
从高质量的 SSNHL 指南中提取候选指标（CIs），并使用评估指南研究和评价 II 工具进行评估。根据有效性、可靠性和测量可行性，由一个由 9 名专家组成的小组对每个 CI 及其支持证据进行总结和审查。使用修改后的 RAND 公司-加利福尼亚大学洛杉矶分校适宜性方法从 CIs 中选择最终 QI。
文献回顾后确定了 15 个 CIs。经过第一轮评估，专家组一致认为 11 个候选指标是合适的 QI，另外还有 2 个 CIs 建议考虑。专家小组会议为讨论分歧领域提供了平台，然后再进行最终评估。随后，专家组一致同意将 11 个最终 QI 作为 SSNHL 高质量护理的适当衡量标准。
本研究提出的 11 个 QI 得到证据和专家共识的支持，便于在广泛的质量领域进行衡量。随着最近更新的 SSNHL 指南和对质量改进机会的更多关注，这些 QI 可被医疗保健提供者用于有针对性的质量改进计划。
