Delphi consensus statement: Quality indicators for Inflammatory Bowel Disease Comprehensive Care Units
Delphi consensus statement: Quality indicators for Inflammatory Bowel Disease Comprehensive Care Units
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DOI：
10.1016/j.crohns.2013.10.010
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发表时间：
2014-03-01
影响因子：
8
通讯作者：
Roldan, Julio
中科院分区：
文献类型：
--
作者：
Calvet, Xavier;Panes, Julian;Roldan, Julio
背景和目的：虽然人们普遍认为炎症性肠病（IBD）综合护理单元（ICCU）有助于为克罗恩病和溃疡性结肠炎患者提供高质量的护理，但如何定义或评估ICCU仍不清楚。本研究的目的是开发一套全面的结构、过程和结果的质量指标（QIs），用于定义和评估ICCU。方法：采用基于德尔菲共识的方法，采用标准化的三步流程来确定一组核心的QIs。该过程包括使用互补方法进行详尽搜索，以确定潜在的QIs，并进行两轮德尔福投票，以选择定义ICCU核心需求的QIs。结果：共识选择了56个核心QIs（12个结构，20个过程和24个结果）。结构和过程质量指标强调了多学科管理和护理连续性的必要性。最小的IBD团队应该包括一名IBD护士、胃肠科医生、放射科医生、外科医生、内窥镜医生和造口管理专家。重症监护病房应能同时提供门诊和住院护理，入院时不应中断护理的连续性。结局质量指标侧重于充分预防疾病并发症和药物不良事件，监测治疗适当性的必要性，以及通过提供充分信息和促进患者参与自己的护理来加强患者自主权的必要性。结论：目前的德尔菲共识确定了一组可能对iccu的评估和认证有用的核心QIs。(C) 2013年作者。由Elsevier B.V.代表欧洲克罗恩病和结肠炎组织出版。版权所有。
Background and aims: While it is commonly accepted that Inflammatory bowel disease (IBD) Comprehensive Care Units (ICCUs) facilitate the delivery of quality care to Crohn's disease and ulcerative colitis patients, it remains unclear how an ICCU should be defined or evaluated. The aim of the present study was to develop a comprehensive set of Quality Indicators (QIs) of structure, process, and outcomes for defining and evaluating an ICCU.Methods: A Delphi consensus-based approach with a standardized three-step process was used to identify a core set of QIs. The process included an exhaustive search using complementary approaches to identify potential QIs, and two Delphi voting rounds to select the QIs defining the core requirements for an ICCU.Results: The consensus selected a core set of 56 QIs (12 structure, 20 process and 24 outcome). Structure and process QIs highlighted the need for multidisciplinary management and continuity of care. The minimal IBD team should include an IBD nurse, gastroenterologists, radiologists, surgeons, endoscopists and stoma management specialists. ICCUs should be able to provide both outpatient and inpatient care and admission should not break the continuity of care. Outcome QIs focused on the adequate prophylaxis of disease complication and drug adverse events, the need to monitor appropriateness of treatment and the need to reinforce patient autonomy by providing adequate information and facilitating the patients' participation in their own care.Conclusions: The present Delphi consensus identified a set of core QIs that may be useful for evaluating and certifying ICCUs. (C) 2013 The Authors. Published by Elsevier B.V. on behalf of European Crohn's and Colitis Organisation. All rights reserved.