Murray Passo, MD, MEd
Medical University of South Carolina
Quality improvement is a mandate for all individuals and institutions in medicine. Pediatric rheumatology is charged with establishing quality measures for Juvenile Rheumatoid Arthritis (JRA) by the American College of Rheumatology and the American Board of Pediatrics. The latter organization will use these measures to register data for rheumatologists to conduct quality improvement projects in order to recertify in rheumatology. The Delphi method is a consensus building tool to establish a set of measures from a group of experts. A national quality measures workgroup housed in Cincinnati has developed an email Delphi survey in order to solicit consensus on quality measures from 60 pediatric rheumatologists, 4 advanced practice nurses, and 31 parents and patients with JRA. The Delphi has gone through one national survey and 7 modifications by the workgroup. The workgroup has reduced the suggested quality measures to items in 5 domains which coincide with the 6 aims of the Institute of Medicine. A broader plan for approval by the American Medical Association Quality Performance Consortium and National Quality Forum has been funded and will follow the Delphi and subsequent face-to-face Nominal Group Technique. Ultimately this will lead to a national collaborative for quality initiative throughout pediatric rheumatology to improve outcomes of children with JRA.
