Improving benchmarking by using an explicit framework for the development of composite indicators: an example using pediatric quality of care

Table 3 Quality matrix for a pediatric intensive care unit quality index

	Safe	Effective	Efficient	Pt-centered	Timely
Structure				Nurse-to-patient ratio	Intensivist in house 24 hours a day
Process	Medication Safety Practice, Central line infection prevention practice, VAP prevention practices	Review of unplanned readmissions		Pain assessment on admission, Periodic pain assessment	Time to receive antibiotics for sepsis
Outcome	VAP rate, BSI rate, UTI rate, Unplanned extubation rate	SMR, Unplanned readmission rate	Severity adjusted LOS		Failed extubation rate

Pt: patient; VAP: ventilator associated pneumonia; BSI: blood stream infection; UTI: urinary tract infection; LOS: length of stay; SMR: standardized mortality ratio.
The italicized items are the eight core metrics in Pedi-QS report. The other items were initially rejected either because of lack of evidence or difficulty in measurement.

ISSN: 1748-5908