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. 2017 Oct 27;11(11):1362-1368.
doi: 10.1093/ecco-jcc/jjx099.

Establishing Key Performance Indicators [KPIs] and Their Importance for the Surgical Management of Inflammatory Bowel Disease-Results From a Pan-European, Delphi Consensus Study

Pritesh S Morar  1   2 , James Hollingshead  1 , Willem Bemelman  3 , Nick Sevdalis  4 , Thomas Pinkney  5   6 , Graeme Wilson  5   6 , Malcolm Dunlop  5   6 , R Justin Davies  5   6 , Richard Guy  5   6 , Nicola Fearnhead  6 , Steven Brown  5   6 , Janindra Warusavitarne  1 , Cathryn Edwards  7 , Omar Faiz  1   5   6
Affiliations

Establishing Key Performance Indicators [KPIs] and Their Importance for the Surgical Management of Inflammatory Bowel Disease-Results From a Pan-European, Delphi Consensus Study

Pritesh S Morar et al. J Crohns Colitis. .

Abstract

Background and aims: Key performance indicators [KPIs] exist across a range of areas in medicine. They help to monitor outcomes, reduce variation, and drive up standards across services. KPIs exist for inflammatory bowel disease [IBD] care, but none specifically cover inflammatory bowel disease [IBD] surgical service provision.

Methods: This was a consensus-based study using a panel of expert IBD clinicians from across Europe. Items were developed and fed through a Delphi process to achieve consensus. Items were ranked on a Likert scale from 1 [not important] to 5 [very important]. Consensus was defined when the inter quartile range was ≤ 1, and items with a median score > 3 were considered for inclusion.

Results: A panel of 21 experts [14 surgeons and 7 gastroenterologists] was recruited. Consensus was achieved on procedure-specific KPIs for ileocaecal and perianal surgery for Crohn's disease, [N = 10] with themes relating to morbidity [N = 7], multidisciplinary input [N = 2], and quality of life [N = 1]; and for subtotal colectomy, proctocolectomy and ileoanal pouch surgery for ulcerative colitis [N = 11], with themes relating to mortality [N = 2], morbidity [N = 8], and service provision [N = 1]. Consensus was also achieved for measures of the quality of IBD surgical service provision and quality assurance in IBD surgery.

Conclusions: This study has provided measurable KPIs for the provision of surgical services in IBD. These indicators cover IBD surgery in general, the governance and structures of the surgical services, and separate indicators for specific subareas of surgery. Monitoring of IBD services with these KPIs may reduce variation across services and improve quality.

Keywords: Delphi; IBD surgery; inflammatory bowel disease.

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Figures

Figure 1.
Figure 1.
Pie chart demonstrating consensus on the number of major inflammatory bowel disease [IBD] resections (including proctocolectomy, subtotal colectomy, ileoanal pouch formation & ileocolonic/small bowel Crohn’s surgery) performed per year by individual consultant colorectal surgeons, to ensure a high quality service provision. Following the second iteration, there was a 9.5% consensus on 5 to 10 major resections, 4.8% consensus on 11 to 15 major resections, 33.3% consensus on 16 to 20 major resections, and 52.4% consensus on more than 20 major resections performed per year by individual consultant colorectal surgeons.
Figure 2.
Figure 2.
Pie chart demonstrating consensus on the number of major inflammatory bowel disease [IBD] resections (including proctocolectomy, subtotal colectomy, ileoanal pouch formation & ileocolonic/small bowel Crohn’s surgery) performed per year by institutions to ensure a high quality service provision; 95.2% of Delphi participants agreed that following two iterations, more than 20 major resections should be performed per institution per year; and 4.8% of Delphi participants agreed that 5 to 10 major resections should be performed per institution per year.
See this image and copyright information in PMC

References

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