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Development of quality indicators to evaluate antibiotic treatment of patients with community‐acquired pneumonia in I ndonesia
Author(s) -
Farida Helmia,
Rondags Angelique,
Gasem M. Hussein,
Leong Katharina,
Adityana A.,
Broek Peterhans J.,
Keuter Monique,
Natsch Stephanie
Publication year - 2015
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12452
Subject(s) - delphi method , medicine , documentation , quality management , delphi , standardization , quality (philosophy) , community acquired pneumonia , pneumonia , intensive care medicine , medical physics , operations management , computer science , engineering , management system , philosophy , epistemology , artificial intelligence , programming language , operating system
Objective To develop an instrument for evaluating the quality of antibiotic management of patients with community‐acquired pneumonia ( CAP ) applicable in a middle‐income developing country. Method A previous study and I ndonesian guidelines were reviewed to derive potential quality of care indicators ( QI s). An expert panel performed a two‐round D elphi consensus procedure on the QI 's relevance to patient recovery, reduction of antimicrobial resistance and cost containment. Applicability in practice, including reliability, feasibility and opportunity for improvement, was determined in a data set of 128 patients hospitalised with CAP in S emarang, I ndonesia. Results Fifteen QI s were selected by the consensus procedure. Five QI s did not pass feasibility criteria, because of inappropriate documentation, inefficient laboratory services or patient factors. Three QI s provided minor opportunity for improvement. Two QI s contradicted each other; one of these was considered not valid and excluded. A final set of six QI s was defined for use in the I ndonesian setting. Conclusion Using the D elphi method, we defined a list of QI s for assessing the quality of care, in particular antibiotic treatment, for CAP in Indonesia. For further improvement, a modified D elphi method that includes discussion, a sound medical documentation system, improvement of microbiology laboratory services, and multi‐center applicability tests are needed to develop a valid and applicable QI list for the I ndonesian setting.