Development of Nurse-Sensitive, Emergency Department–Specific Quality Indicators Using a Modified Delphi Technique

Abstract

Background: 

There is no identified set of nursing-sensitive, emergency department (ED)–specific quality indicators.

Purpose: 

The purpose of this study was to address the gap in quality indicators specific to the emergency care environment and identify a list of nursing-sensitive, ED-specific quality indicators across ED populations and phases of the ED visit for further development and testing.

Methods: 

A modified Delphi technique was used to reach initial consensus.

Results: 

Four thematic groups were identified, and quality indicators within each were rank ordered. Of the 4 groups, 21 quality indicators were identified: triage (6) was ranked highest, followed by special populations (4), transitions of care (4), and medical/surgical (7).

Conclusions: 

Many of the recommended metrics were questionable because they are nonspecific to the ED setting or subject to influences in the emergency care environment. Some identified priorities for quality indicator development were unsupported; we recommend that alternate methodologies be used to identify critical areas of quality measurement.