Establishing gold standards for system-level measures: A modified Delphi consensus process

<p dir="ltr">Doolan-Noble, F., Barson, S., Lyndon, M., Cullinane, F., Gray, J., Stokes, T., & Gauld, R. (2019). Establishing gold standards for System-Level Measures: a modified Delphi consensus process. <i>International Journal for Quality in Health Care</i>, <i>31</i>(3), 205-211.</p><p dir="ltr"><a href="https://academic.oup.com/intqhc/article/31/3/205/5034838" target="_blank">Link to full text</a></p><p dir="ltr"><b>Abstract</b></p><p dir="ltr"><b>Objective:</b><b> </b>To establish aspirational 'gold standards' for a suite of System-Level Measures (SLMs) being used by Counties Manukau Health (CM Health), a New Zealand (NZ) District Health Board.</p><p dir="ltr"><b>Design:</b><b> </b>This study employed a multi-stage, multi-method modified Delphi consensus process.</p><p dir="ltr"><b>Setting:</b><b> </b>The Delphi consensus process involved virtual (email) communication between participants (Round 1) and a structured face-to-face meeting (Round 2) held in Auckland, NZ.</p><p dir="ltr"><b>Participants:</b><b> </b>Participants comprised of health professionals, managers, academics and quality improvement experts with an interest in the use of SLMs.</p><p dir="ltr"><b>Interventions:</b><b> </b>Participants in the first round received a letter requesting their participation in an anonymous Delphi. The second round involved national and international health system experts taking part in a structured, facilitated face-to-face meeting. Participants reviewed 15 SLMs in total. The SLMs all related to the three domains of the Triple Aim: Population Health, e.g. life expectancy at birth; Patient Experience of Care, e.g. rate of adverse events; and Cost and Productivity, e.g. healthcare expenditure per capita.</p><p dir="ltr"><b>Main outcome measures:</b><b> </b>For a proposed gold standard to be agreed and established for each SLM.</p><p dir="ltr"><b>Results:</b><b> </b>Twelve participants took part in Round 1, with 19 participating in Round 2. The process established agreement on a gold standard for each of the 15 reviewed SLMs.</p><p dir="ltr"><b>Conclusion:</b><b> </b>We demonstrated that the Delphi consensus process can be used to establish gold standards for a suite of SLMs used by a NZ Health Board (CM Health).</p><p dir="ltr">PMID: 29889227</p>