title: Quality Measurement in Neonatal Surgical Disorders: Development of Clinical Indicators.
abstract: OBJECTIVE
  This study aims to develop a set of quality indicators for the measurement of the quality of surgical care for neonates with surgical disorders.
  
  
  METHODS
  An expert panel of the Netherlands Association of Pediatric Surgeons developed internal (clinical) indicators for neonatal surgery. This included the selection of appropriate care processes, a review of the scientific literature, consensus meetings to establish national guidelines, selection of clinical indicators with independent external evaluation, the setup of a national database, and a pilot study in one of the hospitals to evaluate the defined quality indicators in clinical practice.
  
  
  RESULTS
  Seven neonatal surgical care processes were selected. Clinical guidelines to evaluate the care processes were established in six of seven disorders and were based on consensus agreement, which was reached in 81 to 97% of in total 220 relevant items. The expert panel selected a set of 24 indicators to estimate the quality of neonatal surgical care, of which 12 were outcome indicators and 12 process indicators.
  
  
  CONCLUSIONS
  The development of quality indicators is an important step toward monitoring and, if necessary, improving the quality of neonatal surgical care. Internal or clinical indicators guarantee that the results are only disclosed to the participating center itself and are therefore no threat to individual doctors.
authors: Department of Pediatric Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors: Ernest
authors: E
authors: van Heurn
authors: Department of Pediatric Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: Ivo
authors: I
authors: de Blaauw
authors: Department of Pediatric Surgery, Pediatric Surgical Centre of Amsterdam, Emma Children's Hospital AMC/VU Medical Centre, Amsterdam, The Netherlands.
authors: Hugo
authors: H
authors: Heij
authors: Department of Pediatric Surgery, Princess Maxima, Center of Pediatric Oncology, Utrecht, The Netherlands.
authors: Marc
authors: M
authors: Wijnen
authors: Department of Pediatric Surgery, Erasmus MC, Rotterdam, The Netherlands.
authors: Rene
authors: R
authors: Wijnen
authors: Department of Pediatric Surgery, University Medical Center Groningen, Hanzeplein, Groningen, The Netherlands.
authors: Jan
authors: J
authors: Hulscher
authors: Department of Pediatric Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: David
authors: D
authors: van der Zee
mesh_terms: D000013:Congenital Abnormalities / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D009359:Neonatology / Q000592:standards*; D009426:Netherlands; D010865:Pilot Projects; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000592:standards; D019984:Quality Indicators, Health Care; D013043:Specialties, Surgical / Q000592:standards*