title: Formal selection of measures for a composite index of NICU quality of care: Baby-MONITOR.
abstract: OBJECTIVE
  To systematically rate measures of care quality for very low birth weight infants for inclusion into Baby-MONITOR, a composite indicator of quality.
  
  
  METHODS
  Modified Delphi expert panelist process including electronic surveys and telephone conferences. Panelists considered 28 standard neonatal intensive care unit (NICU) quality measures and rated each on a 9-point scale taking into account pre-defined measure characteristics. In addition, panelists grouped measures into six domains of quality. We selected measures by testing for rater agreement using an accepted method.
  
  
  RESULTS
  Of 28 measures considered, 13 had median ratings in the high range (7 to 9). Of these, 9 met the criteria for inclusion in the composite: antenatal steroids (median (interquartile range)) 9(0), timely retinopathy of prematurity exam 9(0), late onset sepsis 9(1), hypothermia on admission 8(1), pneumothorax 8(2), growth velocity 8(2), oxygen at 36 weeks postmenstrual age 7(2), any human milk feeding at discharge 7(2) and in-hospital mortality 7(2). Among the measures selected for the composite, the domains of quality most frequently represented included effectiveness (40%) and safety (30%).
  
  
  CONCLUSIONS
  A panel of experts selected 9 of 28 routinely reported quality measures for inclusion in a composite indicator. Panelists also set an agenda for future research to close knowledge gaps for quality measures not selected for the Baby-MONITOR.
authors.affiliation: Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA. profit@bcm.edu
authors.forename: J
authors.initials: J
authors.lastname: Profit
authors.forename: J B
authors.initials: JB
authors.lastname: Gould
authors.forename: J A F
authors.initials: JA
authors.lastname: Zupancic
authors.forename: A R
authors.initials: AR
authors.lastname: Stark
authors.forename: K M
authors.initials: KM
authors.lastname: Wall
authors.forename: M A
authors.initials: MA
authors.lastname: Kowalkowski
authors.forename: M
authors.initials: M
authors.lastname: Mei
authors.forename: K
authors.initials: K
authors.lastname: Pietz
authors.forename: E J
authors.initials: EJ
authors.lastname: Thomas
authors.forename: L A
authors.initials: LA
authors.lastname: Petersen
mesh_terms: D003625:Data Collection; D003697:Delphi Technique; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D011785:Quality Assurance, Health Care; D011787:Quality of Health Care