[Practical considerations for implementing health outcomes measurement projects within a healthcare organization: Delphi Expert Consensus Study]

J Healthc Qual Res. 2022 Sep-Oct;37(5):326-334. doi: 10.1016/j.jhqr.2021.12.008. Epub 2022 Mar 7.
[Article in Spanish]

Abstract

Introduction: Measuring health outcomes and costs per patient is an essential element of value-based healthcare (VBHC). The aim of the study was to generate expert consensus on the activities required to implement it.

Methods: A two-round modified Delphi study with healthcare professionals, quality and clinical management methodologists and managers with academic and/or practical experience in outcome measurement projects. A median equal to or greater than 4 and a relative interquartile range (RIQR) equal to or greater than 25% were established as consensus criteria.

Results: Consensus was obtained on 91% of the items (N=74/81). In terms of feasibility, the items that received the highest score and consensus were the existence of data protection guarantees (median=5; mean=4.8; RIQR=0%), the vision and motivation of healthcare professionals (median=5; mean=4.7; RIQR=20%), the existence and availability of ICT tools (or systems) for data recording (median=5; mean=4.5; RIQR=20%), and having sufficient funding to undertake the project (median=5; mean=4.2; RIQR=20%). The most highly rated factors adding complexity were the number of units or departments involved in the care process for the clinical condition (median=5; mean=4.4; RIQR=20%), having an accepted set of monitoring indicators for the condition (median=5; mean=4.4; RIQR=20%), and the involvement of several levels of care in the project (median=5; mean=4.3; RIQR=20%).

Conclusions: We describe practical aspects for the application of systematic outcomes measurement in routine clinical practice. These results can serve as a tool for prioritising, sizing, resource planning, and estimating implementation costs.

Keywords: Asistencia sanitaria basada en valor; Care innovation; Competencias profesionales; Delphi; Dimensionamiento de recursos; Implantación; Implementation; Innovación asistencial; Professional competencies; Resource sizing; Value-based healthcare.

MeSH terms

  • Consensus
  • Delivery of Health Care*
  • Delphi Technique
  • Health Personnel*
  • Humans
  • Outcome Assessment, Health Care