title: Do practicing clinicians agree with expert ratings of neonatal intensive care unit quality measures?
abstract: OBJECTIVE
  To assess the level of agreement when selecting quality measures for inclusion in a composite index of neonatal intensive care quality (Baby-MONITOR) between two panels: one comprised of academic researchers (Delphi) and another comprised of academic and clinical neonatologists (clinician).
  
  
  METHODS
  In a modified Delphi process, a panel rated 28 quality measures. We assessed clinician agreement with the Delphi panel by surveying a sample of 48 neonatal intensive care practitioners. We asked the clinician group to indicate their level of agreement with the Delphi panel for each measure using a five-point scale (much too high, slightly too high, reasonable, slightly too low and much too low). In addition, we asked clinicians to select measures for inclusion in the Baby-MONITOR based on a yes or no vote and a pre-specified two-thirds majority for inclusion.
  
  
  RESULTS
  In all, 23 (47.9%) of the clinicians responded to the survey. We found high levels of agreement between the Delphi and clinician panels, particularly across measures selected for the Baby-MONITOR. Clinicians selected the same nine measures for inclusion in the composite as the Delphi panel. For these nine measures, 74% of clinicians indicated that the Delphi panel rating was 'reasonable'.
  
  
  CONCLUSIONS
  Practicing clinicians agree with an expert panel on the measures that should be included in the Baby-MONITOR, enhancing face validity.
authors.affiliation: Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: M
authors.initials: M
authors.lastname: Kowalkowski
authors.forename: J B
authors.initials: JB
authors.lastname: Gould
authors.forename: C
authors.initials: C
authors.lastname: Bose
authors.forename: L A
authors.initials: LA
authors.lastname: Petersen
authors.forename: J
authors.initials: J
authors.lastname: Profit
mesh_terms: D001291:Attitude of Health Personnel; D003697:Delphi Technique; D005180:Faculty, Medical; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D009359:Neonatology; D015588:Observer Variation; D058996:Quality Improvement; D019984:Quality Indicators, Health Care / Q000592:standards*; D012108:Research Personnel; D012955:Societies, Medical; D014481:United States