Ruben van Zelm1,2, Ingrid Janssen3, Kris Vanhaecht1,4, Anthony de Buck van Overstraeten5, Massimiliano Panella6, Walter Sermeus1, Ellen Coeckelberghs1. 1. Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium. 2. Q-Consult, Utrecht, the Netherlands. 3. European Pathway Association, Leuven, Belgium. 4. University Hospital Leuven, Leuven, Belgium. 5. Department of Abdominal Surgery, University Hospital Leuven, Leuven, Belgium. 6. Department of Translational Medicine, University of Eastern Piemonte (UPO), Novarra, Italy.
Abstract
RATIONALE, AIMS, AND OBJECTIVES: During the last decades, perioperative care for patients with colorectal cancer has shifted towards more standardized care, so-called "enhanced recovery after surgery." Those programs aim to optimize interventions in perioperative care to decrease the rate of postoperative complications, improve patients' recovery, and shorten hospital stay. The purpose of this literature review is to identify, summarize, and operationalize the clinical content of both key interventions and clinical indicators to develop an evidence-based model pathway for surgical patients with colorectal cancer. METHODS: A systematic search in 3 databases was conducted to identify key interventions (KIs) and indicators to measure the effect of implementation of care pathways. The KIs from the enhanced recovery after surgery protocol were listed and used as framework to identify and match KIs used in the included studies. The Clinical Pathway Compass was used to categorize the indicators. RESULTS: Fifteen studies were included. The number of KI used in the study protocols ranged from 9 to 20. In total, 33 KIs were identified. Little information was available concerning the implementation of and compliance to the protocol. Length of stay and complication rate are the most common used indicators (used in 15/15 and 14/15 of the studies), followed by 21 other measures. All but one of the included studies reported a reduction in length of stay. CONCLUSION: There is a considerable variation in both number of KIs and indicators as well as operationalization of key interventions, for surgical patients with colorectal cancer documented in literature. Therefore, we summarized the input from different studies and developed an evidence-based model pathway, which can serve as a basis for a local/regional care pathway team to build their own pathway.
RATIONALE, AIMS, AND OBJECTIVES: During the last decades, perioperative care for patients with colorectal cancer has shifted towards more standardized care, so-called "enhanced recovery after surgery." Those programs aim to optimize interventions in perioperative care to decrease the rate of postoperative complications, improve patients' recovery, and shorten hospital stay. The purpose of this literature review is to identify, summarize, and operationalize the clinical content of both key interventions and clinical indicators to develop an evidence-based model pathway for surgical patients with colorectal cancer. METHODS: A systematic search in 3 databases was conducted to identify key interventions (KIs) and indicators to measure the effect of implementation of care pathways. The KIs from the enhanced recovery after surgery protocol were listed and used as framework to identify and match KIs used in the included studies. The Clinical Pathway Compass was used to categorize the indicators. RESULTS: Fifteen studies were included. The number of KI used in the study protocols ranged from 9 to 20. In total, 33 KIs were identified. Little information was available concerning the implementation of and compliance to the protocol. Length of stay and complication rate are the most common used indicators (used in 15/15 and 14/15 of the studies), followed by 21 other measures. All but one of the included studies reported a reduction in length of stay. CONCLUSION: There is a considerable variation in both number of KIs and indicators as well as operationalization of key interventions, for surgical patients with colorectal cancer documented in literature. Therefore, we summarized the input from different studies and developed an evidence-based model pathway, which can serve as a basis for a local/regional care pathway team to build their own pathway.
Authors: Ruben van Zelm; Ellen Coeckelberghs; Walter Sermeus; Anthony De Buck van Overstraeten; Arved Weimann; Deborah Seys; Massimiliano Panella; Kris Vanhaecht Journal: Int J Colorectal Dis Date: 2017-07-17 Impact factor: 2.571
Authors: Roberto Latina; Katia Salomone; Daniela D'Angelo; Daniela Coclite; Greta Castellini; Silvia Gianola; Alice Fauci; Antonello Napoletano; Laura Iacorossi; Primiano Iannone Journal: Int J Environ Res Public Health Date: 2020-11-20 Impact factor: 3.390