Department of Health Policy and Organization, School of Public Health, The University of Alabama at Birmingham, Birmingham (Drs Moore, Wingate, and Ford); and Department of Health Services Administration, School of Health Professions, The University of Alabama at Birmingham, Birmingham (Dr Hall).
Qual Manag Health Care. 2023;32(3):161-169. doi: 10.1097/QMH.0000000000000384. Epub 2022 Aug 24.
Public health systems exhibiting strong connections across the workforce experience substantial population health improvements. This is especially important for improving quality and achieving value among vulnerable populations such as mothers and infants. The purpose of this research was to demonstrate how Alabama's newly formed perinatal quality collaborative (Alabama Perinatal Quality Collaborative [ALPQC]) used evidenced-based processes to achieve consensus in identifying population quality improvement (QI) initiatives.
This multiphase quantitative and qualitative study engaged stakeholders (n = 44) at the ALPQC annual meeting. Maternal and neonatal focused QI project topics were identified and catalogued from active perinatal quality collaborative websites. The Delphi method and the nominal group technique (NGT) were used to prioritize topics using selected criteria ( impact , enthusiasm , alignment , and feasibility ) and stakeholder input.
Using the Delphi method, 11 of 27 identified project topics met inclusion criteria for stakeholder consideration. Employing the NGT, maternal projects received more total votes (n = 535) than neonatal projects (n = 313). Standard deviations were higher for neonatal projects (SD: feasibility = 10.9, alignment = 17.9, enthusiasm = 19.2, and impact = 22.1) than for maternal projects (SD: alignment = 5.9, enthusiasm = 7.3, impact = 7.9, and feasibility = 11.1). Hypertension in pregnancy (n = 117) and neonatal abstinence syndrome (n = 177) achieved the most votes total and for impact (n = 35 and n = 54, respectively) but variable support for feasibility .
Together, these techniques achieved valid consensus across multidisciplinary stakeholders in alignment with state public health priorities. This model can be used in other settings to integrate stakeholder input and enhance the value of a common population QI agenda.
公共卫生系统中，各部门之间联系紧密，能够显著提高人群健康水平。对于改善弱势群体（如母婴）的服务质量和实现其价值，这一点尤为重要。本研究旨在展示阿拉巴马州新成立的围产期质量协作组织（Alabama Perinatal Quality Collaborative，ALPQC）如何利用循证过程达成共识，确定人群质量改进（QI）计划。
本多阶段定量和定性研究邀请了 ALPQC 年会的利益相关者（n=44）参与。从活跃的围产期质量协作网站中确定并分类了母婴为重点的 QI 项目主题。使用德尔菲法和名义小组技术（NGT），根据选定的标准（影响、积极性、一致性和可行性）和利益相关者的意见，对主题进行优先级排序。
使用德尔菲法，27 个已确定的项目主题中有 11 个符合利益相关者考虑的纳入标准。采用 NGT，母婴项目获得的总票数（n=535）多于新生儿项目（n=313）。新生儿项目的标准差较高（SD：可行性=10.9，一致性=17.9，积极性=19.2，影响=22.1），而母婴项目的标准差较低（SD：一致性=5.9，积极性=7.3，影响=7.9，可行性=11.1）。妊娠高血压（n=117）和新生儿戒断综合征（n=177）在总票数和影响方面（分别为 n=35 和 n=54）获得了最多的票数，但可行性方面的支持程度不同。
这些技术共同在与州公共卫生重点一致的情况下，在多学科利益相关者之间达成了有效的共识。该模型可用于其他环境，以整合利益相关者的意见并提高共同人群 QI 议程的价值。
