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dc.contributor.authorZurynski, Yvonne
dc.contributor.authorChurruca, Kate
dc.contributor.authorArnolda, Gaston
dc.contributor.authorDalton, Sarah
dc.contributor.authorTing, Hsuen P
dc.contributor.authorHibbert, Peter Damian
dc.contributor.authorMolloy, Charlotte
dc.contributor.authorWiles, Louise K
dc.contributor.authorde Wet, Carl
dc.contributor.authorBraithwaite, Jeffrey
dc.date.accessioned2019-12-10T02:23:08Z
dc.date.available2019-12-10T02:23:08Z
dc.date.issued2019
dc.identifier.issn2044-5415
dc.identifier.doi10.1136/bmjqs-2019-010088
dc.identifier.urihttp://hdl.handle.net/10072/389624
dc.description.abstractObjective To assess quality of care for children presenting with acute abdominal pain using validated indicators. Design Audit of care quality for acute abdominal pain according to 21 care quality indicators developed and validated in four stages. Setting and participants Medical records of children aged 1–15 years receiving care in 2012–2013 were sampled from 57 general practitioners, 34 emergency departments (ED) and 28 hospitals across three Australian states; 6689 medical records were screened for visits for acute abdominal pain and audited by trained paediatric nurses. Outcome measures Adherence to 21 care quality indicators and three bundles of indicators: bundle A-History; bundle B-Examination; bundle C-Imaging. Results Five hundred and fourteen children had 696 visits for acute abdominal pain and adherence was assessed for 9785 individual indicators. The overall adherence was 69.9% (95% CI 64.8% to 74.6%). Adherence to individual indicators ranged from 21.6% for assessment of dehydration to 91.4% for appropriate ordering of imaging. Adherence was low for bundle A-History (29.4%) and bundle B-Examination (10.2%), and high for bundle C-Imaging (91.4%). Adherence to the 21 indicators overall was significantly lower in general practice (62.7%, 95% CI 57.0% to 68.1%) compared with ED (86.0%, 95% CI 83.4% to 88.4%; p<0.0001) and hospital inpatient settings (87.9%, 95% CI 83.1% to 91.8%; p<0.0001). Conclusions There was considerable variation in care quality for indicator bundles and care settings. Future work should explore how validated care quality indicator assessments can be embedded into clinical workflows to support continuous care quality improvement.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherBMJ Publishing Group
dc.publisher.placeUnited Kingdom
dc.relation.ispartofjournalBMJ Quality and Safety
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchPublic Health and Health Services
dc.subject.fieldofresearchCurriculum and Pedagogy
dc.subject.fieldofresearchcode1103
dc.subject.fieldofresearchcode1117
dc.subject.fieldofresearchcode1302
dc.subject.keywordsclinical practice guidelines
dc.subject.keywordsgeneral practice
dc.subject.keywordspaediatrics
dc.subject.keywordsquality improvement
dc.subject.keywordsclinical practice guidelines
dc.titleQuality of care for acute abdominal pain in children
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationZurynski, Y; Churruca, K; Arnolda, G; Dalton, S; Ting, HP; Hibbert, PD; Molloy, C; Wiles, LK; de Wet, C; Braithwaite, J, Quality of care for acute abdominal pain in children., BMJ Quality and Safety, 2019
dcterms.dateAccepted2019-11-10
dcterms.licensehttp://creativecommons.org/licenses/by-nc/4.0/
dc.date.updated2019-12-09T04:08:07Z
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© The Author(s) 2019. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.
gro.hasfulltextFull Text
gro.griffith.authorde Wet, Carl


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