Prioritizing areas for quality marker development in children in UK general practice: extending the use of the nominal group technique.
BACKGROUND
There is a deficiency in the ability to measure the quality of care of children in primary care and there is no professional consensus in UK general practice regarding which quality markers should be used.


OBJECTIVE
To prioritize clinical areas on which to focus quality marker development in paediatric primary care and to describe the challenges in generating professional consensus.


METHODS
We convened an expert panel of GPs with a special interest in child health and using the nominal group technique (NGT), a well-established structured, multistep facilitated group meeting technique, we generated consensus around the key clinical areas to focus quality marker development.


RESULTS
Twelve GPs participated in the expert panel. The eight items agreed by panellists as most important were early recognition of serious illness, whole practice involvement in safeguarding, health promotion, mental health, evidence-based management of common conditions, child and carer friendliness and safe and cost-effective prescribing. Panel members struggled to balance the broad clinical areas while attempting to focus on specific areas that are important. The main challenges included managing panel uncertainty, effective organization, presentation of items for review and group inclination to 'include everything'.


CONCLUSIONS
This is the first consensus study of UK GPs to identify key areas to target quality marker development in children. By using the NGT, we have highlighted front-line health care professionals' priorities to improve the quality of care of children and identified the benefits and challenges of developing consensus in a broad topic area.
Department of Primary Care Health Sciences, University of Oxford, 2nd Floor, 23--38 Hythe Bridge Street, Oxford OX1 2ET, UK. peter.gill@phc.ox.ac.uk
Peter J
PJ
Gill
Paul
P
Hewitson
Ed
E
Peile
Anthony
A
Harnden
D032921:Consensus; D058006:General Practice / Q000592:standards*; D006126:Group Processes; D006801:Humans; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000592:standards; D006113:United Kingdom