Establishing Key Performance Indicators [KPIs] and Their Importance for the Surgical Management of Inflammatory Bowel Disease-Results From a Pan-European, Delphi Consensus Study

被引:30
作者
Morar, Pritesh S. [1 ,2 ]
Hollingshead, James [1 ]
Bemelman, Willem [3 ]
Sevdalis, Nick [4 ]
Pinkney, Thomas [5 ,6 ]
Wilson, Graeme [5 ,6 ]
Dunlop, Malcolm [5 ,6 ]
Davies, R. Justin [5 ,6 ]
Guy, Richard [5 ,6 ]
Fearnhead, Nicola [6 ]
Brown, Steven [5 ,6 ]
Warusavitarne, Janindra [1 ]
Edwards, Cathryn [7 ]
Faiz, Omar [1 ,5 ,6 ]
机构
[1] St Marks Hosp & Acad Inst, SETOC, London, England
[2] Imperial Coll, Dept Surg & Canc, London, England
[3] Amsterdam Med Ctr, Dept Surg, Amsterdam, Netherlands
[4] Kings Coll London, Ctr Implementat Sci, London, England
[5] Assoc Coloproctol Great Britain & Ireland ACPGBI, Inflammatory Bowel Dis IBD Subcommittee, London, England
[6] Assoc Coloproctol Great Britain & Ireland ACPGBI, IBD, CAG, London, England
[7] South Devon NHS Fdn Trust, Torquay, England
关键词
Delphi; IBD surgery; inflammatory bowel disease; COLORECTAL SURGERY SICCR; POUCH-ANAL ANASTOMOSIS; QUALITY-OF-CARE; CROHNS-DISEASE; ULCERATIVE-COLITIS; ILEOCOLONIC RESECTION; ITALIAN SOCIETY; TERM OUTCOMES; THINK-TANK; GUIDELINES;
D O I
10.1093/ecco-jcc/jjx099
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and Aims: Key performance indicators [KPIs] exist across a range of areas in medicine. They help to monitor outcomes, reduce variation, and drive up standards across services. KPIs exist for inflammatory bowel disease [IBD] care, but none specifically cover inflammatory bowel disease [IBD] surgical service provision. Methods: This was a consensus-based study using a panel of expert IBD clinicians from across Europe. Items were developed and fed through a Delphi process to achieve consensus. Items were ranked on a Likert scale from 1 [not important] to 5 [very important]. Consensus was defined when the inter quartile range was <= 1, and items with a median score > 3 were considered for inclusion. Results: A panel of 21 experts [14 surgeons and 7 gastroenterologists] was recruited. Consensus was achieved on procedure-specific KPIs for ileocaecal and perianal surgery for Crohn's disease, [N = 10] with themes relating to morbidity [N = 7], multidisciplinary input [N = 2], and quality of life [N = 1]; and for subtotal colectomy, proctocolectomy and ileoanal pouch surgery for ulcerative colitis [N = 11], with themes relating to mortality [N = 2], morbidity [N = 8], and service provision [N = 1]. Consensus was also achieved for measures of the quality of IBD surgical service provision and quality assurance in IBD surgery. Conclusions: This study has provided measurable KPIs for the provision of surgical services in IBD. These indicators cover IBD surgery in general, the governance and structures of the surgical services, and separate indicators for specific subareas of surgery. Monitoring of IBD services with these KPIs may reduce variation across services and improve quality.
引用
收藏
页码:1362 / 1368
页数:7
相关论文
共 38 条
[1]   Single measures of performance do not reflect overall institutional quality in colorectal cancer surgery [J].
Almoudaris, Alex M. ;
Burns, Elaine M. ;
Bottle, Alex ;
Aylin, Paul ;
Darzi, Ara ;
Vincent, Charles ;
Faiz, Omar .
GUT, 2013, 62 (03) :423-429
[2]  
[Anonymous], 1969, DELPHI METHOD EXPT S
[3]  
[Anonymous], 2013, GUID DEV KEY PERF IN
[4]  
Association of Coloproctology of Great Britain and Ireland (ACPGBI), 2012, COL CANC SURG STAND
[5]   What's measured is what matters: Targets and gaming in the English public health care system [J].
Bevan, Gwyn ;
Hood, Christopher .
PUBLIC ADMINISTRATION, 2006, 84 (03) :517-538
[6]   Patient and physician views on the quality of care in inflammatory bowel disease: Results from SOLUTION-I, a prospective IG-IBD study [J].
Bortoli, Aurora ;
Daperno, Marco ;
Kohn, Anna ;
Politi, Patrizia ;
Marconi, Stefano ;
Monterubbianesi, Rita ;
Castiglione, Fabiana ;
Corbellini, Ada ;
Merli, Manuela ;
Casella, Giovanni ;
D'Inca, Renata ;
Orlando, Ambrogio ;
Bossa, Fabrizio ;
Doldo, Patrizia ;
Lecis, Pierenrico ;
Valpiani, Daniela ;
Danese, Silvio ;
Comberlato, Michele .
JOURNAL OF CROHNS & COLITIS, 2014, 8 (12) :1642-1652
[7]  
BSG, 2009, QUAL CAR SERV STAND
[8]   Volume analysis of outcome following restorative proctocolectomy [J].
Burns, E. M. ;
Bottle, A. ;
Aylin, P. ;
Clark, S. K. ;
Tekkis, P. P. ;
Darzi, A. ;
Nicholls, R. J. ;
Faiz, O. .
BRITISH JOURNAL OF SURGERY, 2011, 98 (03) :408-417
[9]   Variation in reoperation after colorectal surgery in England as an indicator of surgical performance: retrospective analysis of Hospital Episode Statistics [J].
Burns, Elaine M. ;
Bottle, Alex ;
Aylin, Paul ;
Darzi, Ara ;
Nicholls, R. John ;
Faiz, Omar .
BMJ-BRITISH MEDICAL JOURNAL, 2011, 343
[10]   Population-based cohort study comparing 30-and 90-day institutional mortality rates after colorectal surgery [J].
Byrne, B. E. ;
Mamidanna, R. ;
Vincent, C. A. ;
Faiz, O. .
BRITISH JOURNAL OF SURGERY, 2013, 100 (13) :1810-1817