Abstract

Key performance indicators (KPIs) are measures of specific elements of care (structures, processes and/or outcomes), which can help us to judge the quality of care given. In this paper, we describe how we worked with women and men with lived experience, doctors, nurses, managers, and others, to develop and agree on a list KPIs for recurrent miscarriage care in Ireland. Participants filled out surveys and took part in meetings to vote and agree on what KPIs were important to include. They also shared their views and experiences of taking part in this work. Together, we developed 110 KPIs for recurrent miscarriage care. These include measures of how care is structured, counselling and supports, investigations and treatments provided, and health-related outcomes. Participants valued the different views that people brought to discussions and what they learned. They suggested ways that the process could be made more participant-friendly. For example, being up-front about the time it would take, explaining medical terms more, and reducing the number of items to be rated in surveys. It is important and possible to develop KPIs with different groups, particularly those with lived experience. Learning from our study may help others who want to do similar projects.

Infographic text

• Developing guideline-based key performance indicators for recurrent miscarriage care: Lessons from a multi-stage consensus process with a diverse stakeholder group.
• Background: We developed guideline-based key performance indicators (KPIs) for recurrent miscarriage care with a diverse stakeholder group, to be used in a national service evaluation. Such exercises have generally only involved clinicians. We aimed to address the gap in the evidence around how to best involve different stakeholders (including patient and public involvement contributors) in such processes.
• Methods: Six-phase consensus with people with clinical, research and lived experience: Identification & synthesis of recommendations; Two-round e-Delphi survey; Four virtual consensus meetings; Development of list of candidate KPIs; Survey to achieve consensus on final KPI suite; Virtual meeting to agree on final KPI suite.
• Findings: Participants valued the different views that people brought to discussions and what they learned. They suggested ways that the process could be made more participant-friendly. For example, being up-front about the time commitment, providing greater explanations around medical terms, and reducing the number of items to be rated in surveys.
• Recommendations: It is important and feasible to develop guideline-based KPIs with a diverse stakeholder group. 110 KPIs were prioritised for inclusion in the final suite. Insights into our experiences may help others undertaking similar projects, particularly those undertaken in the absence of a clinical guideline and/or involving a range of stakeholders.