Defining the Denominator for Measuring Quality of End-of-Life Care in Children with Cancer: Results of a Nominal Group Technique - 09/07/24
, Raba Tefera, BA 1, Prasanna Ananth, MD, MPH 3, 4, Isaac Martinez, BA 1, Amy Porter, MD, PhD 5, Jennifer M. Snaman, MD, MS 5, Rachel Thienprayoon, MD, MS 6, 7, Steve Asch, MD, MPH 8, Smita Bhatia, MD, MPH 1, 2, Ronan O'Beirne, EdD 9Abstract |
Objective |
To determine which groups of children with cancer for whom to apply the newly developed quality measures (QMs) for end-of-life (EOL) care.
Study design |
In a series of nominal groups, panelists answered the question: “Which children, diagnoses, conditions, or prognoses should be included when examining the quality of EOL care for children with cancer?” In each group, individual panelists proposed answers to the question. After collating individual responses, each panelist ranked their 5 top answers and points were assigned (5 pts for the best answer, 4 pts the second best, etc.). A team of pediatric oncology and palliative care clinician-scientists developed and applied a coding structure for responses and associated themes and subthemes for responses.
Results |
We conducted 5 nominal groups with a total of 44 participants. Most participants identified as female (88%) and non-Hispanic White (86%). Seventy-nine percent were clinicians, mainly in pediatric palliative care, pediatric oncology, or hospice; 40% were researchers and 12% were bereaved parents. Responses fell into 5 themes: (1) poor prognosis cancer; (2) specific treatment scenarios; (3) certain populations; (4) certain symptoms; and (5) specific utilization scenarios. Poor prognosis cancer and specific treatment scenarios received the most points (320 pts [49%] and 147 pts [23%], respectively).
Conclusions |
Participants developed a framework to identify which children should be included in EOL QMs for children with cancer. The deliberate identification of the denominator for pediatric QMs serves as a potent tool for enhancing quality, conducting research, and developing clinical programs.
Le texte complet de cet article est disponible en PDF.Keywords : Nominal Group technique, pediatric palliative care, end-of-life care, pediatric oncology, quality measures
Abbreviations : BMT, GVHD, EOL, QMs, NGT, PPC, SME
Plan
| Previous Presentation: This work was presented as a poster at the American Society of Clinical Oncology Quality Symposium in October 2023, but has not otherwise been presented. |
Vol 271
Article 114038- août 2024 Retour au numéro
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