[Emergency departments: pediatric quality indicators as guide to quality assurance].
BACKGROUND
Measuring the quality of care in emergency departments requires tools to quantify the most important aspects in the care process. The quality indicator is the quantitative measure used in quality assurance.


OBJECTIVE
To review the document created by the Catalan Society of Emergency Medicine (SCME) and the Avedis Donabedian Foundation (FAD) in which the quality indicators for the emergency departments were established and to incorporate their methodology and select the indicators that could be adapted to pediatric emergencies. To add new indicators that, in the opinion of experts in pediatric emergencies, could be useful in daily pediatric care. To agree on the definitive list of indicators for use in pediatric emergencies and to define those that will be considered the main indicators. To develop a document on behalf of the Spanish Society of Pediatric Emergencies (SEUP), which will serve as a reference in quality of care.


METHODS
In the first stage, a Working Group of the SEUP was formed. The SCME/FAD paper was distributed after exclusion of the indicators that were not applicable to children. Each member adapted the indicators and proposed others. The Working Group then chose a set of indicators considered essential in any pediatric emergency department.


RESULTS
The final document has 89 indicators, each with the following parameters: dimension, justification, ratio, explanation of terms, population, type, sources of information, standard and comments. Depending on the content, they are classified in one of the following sections: diseases, activities and work areas. Eighteen indicators were adapted to the pediatric age group. Twenty new indicators were added and 12 were proposed as basic or essential.


CONCLUSIONS
The quality indicators are useful in measuring concrete and specific aspects of clinical care and in providing information on quality. The indicators provide valid, reliable and objective information. The indicator is an early warning sign to identify areas requiring improvement and allows appropriate measures to be taken to correct the detected deficiencies. The use of indicators allows comparisons with uniform criteria to be made.
D004636:Emergency Service, Hospital / Q000592:standards*; D017408:Guidelines as Topic; D006801:Humans; D010372:Pediatrics / Q000592:standards*; D011785:Quality Assurance, Health Care; D013030:Spain