Department of Life Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2021 Jul;25(13):4597-4610. doi: 10.26355/eurrev_202107_26252.
The study aims to define the set of Key Performance Indicators (KPIs) required to assess the Value delivered by managing patients with Clostridioides difficile infection through a Critical Pathway. We used the quadruple aim Value-Based approach, and we validated the set of KPIs with the Delphi method.
The study focuses on patients on board a Critical Pathway on Clostridioides difficile Infection and targeted towards a Fecal Microbiota Transplantation (FMT). FMT has been used to successfully treat recurrent Clostridium difficile infection. A two-round e-Delphi survey collecting data was conducted in 2019-2020 to validate the Value-Based evaluation tool. The Value-Based criteria taken into account are Clinical Outcomes, Experience of Care, Per-capita cost, Physician's burnout.
The two rounds led to the validation of 50 items, and four primary clinical outcomes (Mortality rate, length of stay, readmission and complications related to the illness).
The evaluation tool included is validated in its totality and can provide a comprehensive overview of the Value created by the Critical pathway for patients with Clostridioides difficile. We can extend the approach illustrated in this study can also to evaluate other Critical pathways.
本研究旨在确定一套关键绩效指标（KPI），用于评估通过关键路径管理艰难梭菌感染患者所带来的价值。我们采用了基于价值的四重目标方法，并通过德尔菲法对 KPI 集进行了验证。
本研究的重点是在艰难梭菌感染关键路径上的患者，并针对粪便微生物群移植（FMT）。FMT 已成功用于治疗复发性艰难梭菌感染。2019-2020 年进行了两轮电子德尔菲调查，以验证基于价值的评估工具。所考虑的基于价值的标准是临床结果、护理体验、人均成本和医生倦怠。
两轮调查共验证了 50 项指标，以及四项主要临床结果（死亡率、住院时间、再入院和与疾病相关的并发症）。
所包含的评估工具已全面验证，可以全面了解艰难梭菌患者的关键路径所创造的价值。我们可以将本研究中说明的方法扩展到评估其他关键路径。
