{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T03:42:04Z","timestamp":1771299724223,"version":"3.50.1"},"reference-count":55,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE:<\/jats:title>\n                  <jats:p>Identifying gaps in care and improving outcomes for severely ill children requires the development of evidence-based performance measures. We used a systematic process involving multiple stakeholders to identify and develop evidence-based quality indicators for high acuity pediatric conditions relevant to any emergency department (ED) setting where children are seen.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>A prioritized list of clinical conditions was selected by an advisory panel. A systematic review of the literature was conducted to identify existing indicators, as well as guidelines and evidence that could be used to inform the creation of new indicators. A multiphase, Rand-modified Delphi method consisting of anonymous questionnaires and a face-to-face meeting of an expert panel was used for indicator selection. Measure specifications and evidence grading were created for each indicator, and the feasibility and reliability of measurement was assessed in a tertiary care pediatric ED.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>The conditions selected for indicator development were diabetic ketoacidosis, status asthmaticus, anaphylaxis, status epilepticus, severe head injury, and sepsis. The majority of the 62 selected indicators reflect ED processes (84%) with few indicators reflecting structures (11%) or outcomes (5%). Thirty-seven percent (n = 23) of the selected indicators are based on moderate or high quality evidence. Data were available and interrater reliability acceptable for the majority of indicators.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>A systematic process involving multiple stakeholders was used to develop evidence-based quality indicators for high acuity pediatric conditions. Future work will test the reliability and feasibility of data collection on these indicators across the spectrum of ED settings that provide care for children.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2013-0854","type":"journal-article","created":{"date-parts":[[2013,9,24]],"date-time":"2013-09-24T05:48:51Z","timestamp":1380001731000},"page":"752-762","source":"Crossref","is-referenced-by-count":44,"title":["Quality Indicators for High Acuity Pediatric Conditions"],"prefix":"10.1542","volume":"132","author":[{"given":"Antonia S.","family":"Stang","sequence":"first","affiliation":[{"name":"Division of Emergency Medicine, Alberta Children\u2019s Hospital, Alberta Children\u2019s Hospital Research Institute,"},{"name":"Departments of Pediatrics and Community Health Sciences,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon E.","family":"Straus","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Geriatric Medicine, University of Toronto, and Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital and University of Toronto, Toronto, Ontario; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Crotts","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Alberta Children\u2019s Hospital, Alberta Children\u2019s Hospital Research Institute,"},{"name":"Pediatrics, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David W.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Alberta Children\u2019s Hospital, Alberta Children\u2019s Hospital Research Institute,"},{"name":"Pediatrics, Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Astrid","family":"Guttmann","sequence":"additional","affiliation":[{"name":"Division of Pediatric Medicine, Hospital for Sick Children, Department of Pediatrics and Health Policy, Management and Evaluation, University of Toronto and Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2013,10,1]]},"reference":[{"key":"2021121006552484400_B1"},{"key":"2021121006552484400_B2","volume-title":"Crossing the Quality Chasm: A New Health System for the 21st Century","author":"Institute of Medicine","year":"2001"},{"issue":"1 pt 2","key":"2021121006552484400_B3","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1542\/peds.113.S1.199","article-title":"Quality measures for children\u2019s health care.","volume":"113","author":"Beal","year":"2004","journal-title":"Pediatrics"},{"issue":"7258","key":"2021121006552484400_B4","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1136\/bmj.321.7258.425","article-title":"Prescribing indicators for UK general practice: Delphi consultation study.","volume":"321","author":"Campbell","year":"2000","journal-title":"BMJ"},{"issue":"12","key":"2021121006552484400_B5","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1056\/NEJMp078102","article-title":"Eulogy for a quality measure.","volume":"357","author":"Lee","year":"2007","journal-title":"N Engl J Med"},{"issue":"20","key":"2021121006552484400_B6","doi-asserted-by":"crossref","first-page":"2604","DOI":"10.1001\/jama.285.20.2604","article-title":"A qualitative study of increasing beta-blocker use after myocardial infarction: why do some hospitals succeed?","volume":"285","author":"Bradley","year":"2001","journal-title":"JAMA"},{"issue":"7393","key":"2021121006552484400_B7","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1136\/bmj.326.7393.816","article-title":"Research methods used in developing and applying quality indicators in primary care.","volume":"326","author":"Campbell","year":"2003","journal-title":"BMJ"},{"issue":"12","key":"2021121006552484400_B8","doi-asserted-by":"crossref","first-page":"1743","DOI":"10.1001\/jama.1988.03410120089033","article-title":"The quality of care. 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