학술논문

Quality indicators for ambulatory colectomy: literature search and expert consensus.
Document Type
Article
Source
Surgical Endoscopy & Other Interventional Techniques. Apr2024, Vol. 38 Issue 4, p1894-1901. 8p.
Subject
*CLINICAL medicine
*HOME care services
*MEDICAL quality control
*HUMAN services programs
*T-test (Statistics)
*OUTPATIENT medical care
*KEY performance indicators (Management)
*PILOT projects
*PREOPERATIVE care
*ANESTHESIOLOGISTS
*DESCRIPTIVE statistics
*CONVALESCENCE
*DELPHI method
*SURGICAL site infections
*COLECTOMY
*PERIOPERATIVE care
Language
ISSN
1866-6817
Abstract
Background: Care for patients undergoing elective colectomy has become increasingly standardized using Enhanced Recovery Programs (ERP). ERP, encorporating minimally invasive surgery (MIS), decreased postoperative morbidity and length of stay (LOS). However, disruptive changes are needed to safely introduce colectomy in an ambulatory or same-day discharge (SDD) setting. Few research groups showed the feasibility of ambulatory colectomy. So far, no minimum standards for the quality of care of this procedure have been defined. This study aims to identify quality indicators (QIs) that assess the quality of care for ambulatory colectomy. Methods: A literature search was performed to identify recommendations for ambulatory colectomy. Based on that search, a set of QIs was identified and categorized into seven domains: preparation of the patient (pre-admission), anesthesia, surgery, in-hospital monitoring, home monitoring, feasibility, and clinical outcomes. This list was presented to a panel of international experts (surgeons and anesthesiologists) in a 1 round Delphi to assess the relevance of the proposed indicators. Results: Based on the literature search (2010–2021), 3841 results were screened on title and abstract for relevant information. Nine papers were withheld to identify the first set of QIs (n = 155). After excluding duplicates and outdated QIs, this longlist was narrowed down to 88 indicators. Afterward, consensus was reached in a 1 round Delphi on a final list of 32 QIs, aiming to be a comprehensive set to evaluate the quality of ambulatory colectomy care. Conclusion: We propose a list of 32 QI to guide and evaluate the implementation of ambulatory colectomy. [ABSTRACT FROM AUTHOR]

Online Access