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Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews

Clinical or care pathways are developed by a multidisciplinary team of healthcare practitioners, based on clinical evidence, and standardized processes. The evaluation of their framework/content quality is unclear. The aim of this study was to describe which tools and domains are able to critically...

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Autores principales: Latina, Roberto, Salomone, Katia, D’Angelo, Daniela, Coclite, Daniela, Castellini, Greta, Gianola, Silvia, Fauci, Alice, Napoletano, Antonello, Iacorossi, Laura, Iannone, Primiano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699889/
https://www.ncbi.nlm.nih.gov/pubmed/33233824
http://dx.doi.org/10.3390/ijerph17228634
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author Latina, Roberto
Salomone, Katia
D’Angelo, Daniela
Coclite, Daniela
Castellini, Greta
Gianola, Silvia
Fauci, Alice
Napoletano, Antonello
Iacorossi, Laura
Iannone, Primiano
author_facet Latina, Roberto
Salomone, Katia
D’Angelo, Daniela
Coclite, Daniela
Castellini, Greta
Gianola, Silvia
Fauci, Alice
Napoletano, Antonello
Iacorossi, Laura
Iannone, Primiano
author_sort Latina, Roberto
collection PubMed
description Clinical or care pathways are developed by a multidisciplinary team of healthcare practitioners, based on clinical evidence, and standardized processes. The evaluation of their framework/content quality is unclear. The aim of this study was to describe which tools and domains are able to critically evaluate the quality of clinical/care pathways. An overview of systematic reviews was conducted, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses, using Medline, Embase, Science Citation Index, PsychInfo, CINAHL, and Cochrane Library, from 2015 to 2020, and with snowballing methods. The quality of the reviews was assessed with Assessment the Methodology of Systematic Review (AMSTAR-2) and categorized with The Leuven Clinical Pathway Compass for the definition of the five domains: processes, service, clinical, team, and financial. We found nine reviews. Three achieved a high level of quality with AMSTAR-2. The areas classified according to The Leuven Clinical Pathway Compass were: 9.7% team multidisciplinary involvement, 13.2% clinical (morbidity/mortality), 44.3% process (continuity-clinical integration, transitional), 5.6% financial (length of stay), and 27.0% service (patient-/family-centered care). Overall, none of the 300 instruments retrieved could be considered a gold standard mainly because they did not cover all the critical pathway domains outlined by Leuven and Health Technology Assessment. This overview shows important insights for the definition of a multiprinciple framework of core domains for assessing the quality of pathways. The core domains should consider general critical aspects common to all pathways, but it is necessary to define specific domains for specific diseases, fast pathways, and adapting the tool to the cultural and organizational characteristics of the health system of each country.
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spelling pubmed-76998892020-11-29 Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews Latina, Roberto Salomone, Katia D’Angelo, Daniela Coclite, Daniela Castellini, Greta Gianola, Silvia Fauci, Alice Napoletano, Antonello Iacorossi, Laura Iannone, Primiano Int J Environ Res Public Health Review Clinical or care pathways are developed by a multidisciplinary team of healthcare practitioners, based on clinical evidence, and standardized processes. The evaluation of their framework/content quality is unclear. The aim of this study was to describe which tools and domains are able to critically evaluate the quality of clinical/care pathways. An overview of systematic reviews was conducted, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses, using Medline, Embase, Science Citation Index, PsychInfo, CINAHL, and Cochrane Library, from 2015 to 2020, and with snowballing methods. The quality of the reviews was assessed with Assessment the Methodology of Systematic Review (AMSTAR-2) and categorized with The Leuven Clinical Pathway Compass for the definition of the five domains: processes, service, clinical, team, and financial. We found nine reviews. Three achieved a high level of quality with AMSTAR-2. The areas classified according to The Leuven Clinical Pathway Compass were: 9.7% team multidisciplinary involvement, 13.2% clinical (morbidity/mortality), 44.3% process (continuity-clinical integration, transitional), 5.6% financial (length of stay), and 27.0% service (patient-/family-centered care). Overall, none of the 300 instruments retrieved could be considered a gold standard mainly because they did not cover all the critical pathway domains outlined by Leuven and Health Technology Assessment. This overview shows important insights for the definition of a multiprinciple framework of core domains for assessing the quality of pathways. The core domains should consider general critical aspects common to all pathways, but it is necessary to define specific domains for specific diseases, fast pathways, and adapting the tool to the cultural and organizational characteristics of the health system of each country. MDPI 2020-11-20 2020-11 /pmc/articles/PMC7699889/ /pubmed/33233824 http://dx.doi.org/10.3390/ijerph17228634 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Latina, Roberto
Salomone, Katia
D’Angelo, Daniela
Coclite, Daniela
Castellini, Greta
Gianola, Silvia
Fauci, Alice
Napoletano, Antonello
Iacorossi, Laura
Iannone, Primiano
Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews
title Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews
title_full Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews
title_fullStr Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews
title_full_unstemmed Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews
title_short Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews
title_sort towards a new system for the assessment of the quality in care pathways: an overview of systematic reviews
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699889/
https://www.ncbi.nlm.nih.gov/pubmed/33233824
http://dx.doi.org/10.3390/ijerph17228634
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