[Quality care indicators for neonates with selected pathologies: pilot study]

Salud Publica Mex. 2019 Ene-Feb;61(1):35-45. doi: 10.21149/9271.
[Article in Spanish]

Abstract

Objective: Develop and pilot indicators of quality of care to neonates with relevant conditions in Mexico (prematurity, neonatal sepsis, perinatal asphyxia, and intrauterine hypoxia).

Materials and methods: Own indicators were built based on key recommendations of national clinical practice guidelines and indicators found in international repositories. With previous search, selection and prioritization, the indicators were piloted within two hospitals. The feasibility of measuring, (kappa index) reliability and usefulness was analyzed to detect quality problems.

Results: 23 indicators were selected and piloted, 12 are compounds, of the total, nine were feasible and reliable. The quality of the hospital's information was diverse and often poor, limiting both the feasibility and the reliability of the indicators. Improvement opportunities were identified thorough the compliance levels.

Conclusions: A set of nine indicators valid, reliable, feasible and useful indicators is proposed in order to monitor the quality of care of pathological neonates.

Objetivo: Desarrollar y pilotar indicadores de calidad de la atención a neonatos con padecimientos relevantes en México (prematuridad, sepsis neonatal, asfixia perinatal e hipoxia intrauterina).

Material y métodos: Se construyeron indicadores propios a partir de recomendaciones clave de las guías de práctica clínica nacionales e indicadores encontrados en repositorios internacionales. Previa búsqueda, selección y priorización, los indicadores fueron pilotados en dos hospitales. Se analizó la factibilidad de medición, fiabilidad (índice kappa) y utilidad para detectar problemas de calidad.

Resultados: Se seleccionaron y pilotaron 23 indicadores; 12 eran compuestos. Del total, nueve fueron factibles y fiables. La calidad de la información en los hospitales fue diversa y frecuentemente deficiente, limitando tanto la factibilidad como la fiabilidad de los indicadores. Los niveles de cumplimiento identificaron oportunidades de mejora.

Conclusiones: Se propone un set de nueve indicadores válidos, factibles, fiables y útiles para la monitorización de la calidad en la atención a neonatos patológicos.

Keywords: hypoxia; neonatal asphyxia; neonatal sepsis; quality indicators.

MeSH terms

  • Asphyxia Neonatorum / epidemiology*
  • Data Accuracy
  • Female
  • Fetal Hypoxia / epidemiology*
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / epidemiology
  • Male
  • Mexico / epidemiology
  • Neonatal Sepsis / epidemiology*
  • Pilot Projects
  • Practice Guidelines as Topic
  • Quality Improvement
  • Quality Indicators, Health Care*
  • Quality of Health Care
  • Reproducibility of Results