TY - JOUR
T1 - Assessing the adherence to guidelines in the management of croup in Australian children: A population-based sample survey
AU - Prentice, Bernadette
AU - Moloney, Susan
AU - Hort, Jason
AU - Hibbert, Peter
AU - Wiles, Louise K.
AU - Molloy, Charlotte J.
AU - Arnolda, Gaston
AU - Ting, Hsuen P.
AU - Braithwaite, Jeffrey
AU - Jaffe, Adam
N1 - Funding Information:
This work was supported by an Australian National Health and Medical Research Council Partnership Grant (no. 1065898) with contributions from the BUPA Health Foundation, Sydney Children’s Hospitals Network, New South Wales Kids and Families, Children’s Health Queensland and South Australia Department of Health.
Funding Information:
This work was supported by an Australian National Health and Medical Research Council Partnership Grant (no. 1065898) with contributions from the BUPA Health Foundation, Sydney Children?s Hospitals Network, New South Wales Kids and Families, Children?s Health Queensland and South Australia Department of Health.
Publisher Copyright:
© The Author(s) 2019. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Objective: To determine the extent to which care received by Australian children presenting with croup is in agreement with Clinical Practice Guidelines (CPGs). Design: Retrospective population-based sample survey. Croup clinical indicators were derived from CPGs. Data sources/study setting: Medical records from three healthcare settings were sampled for selected visits in 2012 and 2013 in three Australian states. Data collection: Data were collected by nine experienced paediatric nurses, trained to assess eligibility for indicator assessment and adherence to CPGs. Surveyors undertook criterion-based medical record reviews using an electronic data collection tool. Results: Documented guideline adherence was lower for general practitioners (65.9%; 95% CI: 60.8–70.6) than emergency departments (91.1%; 95% CI: 89.5–92.5) and inpatient admissions (91.3%; 95% CI: 88.1–93.9). Overall adherence was very low for a bundle of 10 indicators related to assessment (4.5%; 95% CI: 2.4–7.6) but higher for a bundle of four indicators relating to the avoidance of inappropriate therapy (83.1%; 95% CI: 59.5–96.0). Conclusions: Most visits for croup were characterized by appropriate treatment in all healthcare settings. However, most children had limited documented clinical assessments, and some had unnecessary tests or inappropriate therapy, which has potential quality and cost implications. Universal CPG and clinical assessment tools may increase clinical consistency.
AB - Objective: To determine the extent to which care received by Australian children presenting with croup is in agreement with Clinical Practice Guidelines (CPGs). Design: Retrospective population-based sample survey. Croup clinical indicators were derived from CPGs. Data sources/study setting: Medical records from three healthcare settings were sampled for selected visits in 2012 and 2013 in three Australian states. Data collection: Data were collected by nine experienced paediatric nurses, trained to assess eligibility for indicator assessment and adherence to CPGs. Surveyors undertook criterion-based medical record reviews using an electronic data collection tool. Results: Documented guideline adherence was lower for general practitioners (65.9%; 95% CI: 60.8–70.6) than emergency departments (91.1%; 95% CI: 89.5–92.5) and inpatient admissions (91.3%; 95% CI: 88.1–93.9). Overall adherence was very low for a bundle of 10 indicators related to assessment (4.5%; 95% CI: 2.4–7.6) but higher for a bundle of four indicators relating to the avoidance of inappropriate therapy (83.1%; 95% CI: 59.5–96.0). Conclusions: Most visits for croup were characterized by appropriate treatment in all healthcare settings. However, most children had limited documented clinical assessments, and some had unnecessary tests or inappropriate therapy, which has potential quality and cost implications. Universal CPG and clinical assessment tools may increase clinical consistency.
UR - http://www.scopus.com/inward/record.url?scp=85082542695&partnerID=8YFLogxK
U2 - 10.1093/intqhc/mzz088
DO - 10.1093/intqhc/mzz088
M3 - Review article
C2 - 31665290
AN - SCOPUS:85082542695
SN - 1353-4505
VL - 31
SP - 759
EP - 767
JO - International Journal for Quality in Health Care
JF - International Journal for Quality in Health Care
IS - 10
ER -
