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

Author

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  • Roberto Latina

    (National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy)

  • Katia Salomone

    (National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy)

  • Daniela D’Angelo

    (National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy)

  • Daniela Coclite

    (National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy)

  • Greta Castellini

    (Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy)

  • Silvia Gianola

    (Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy)

  • Alice Fauci

    (National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy)

  • Antonello Napoletano

    (National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy)

  • Laura Iacorossi

    (National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy)

  • Primiano Iannone

    (National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy)

Abstract

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.

Suggested Citation

  • Roberto Latina & Katia Salomone & Daniela D’Angelo & Daniela Coclite & Greta Castellini & Silvia Gianola & Alice Fauci & Antonello Napoletano & Laura Iacorossi & Primiano Iannone, 2020. "Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews," IJERPH, MDPI, vol. 17(22), pages 1-16, November.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:22:p:8634-:d:448583
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    References listed on IDEAS

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    1. Matteo Ruggeri & Chiara Cadeddu & Paolo Roazzi & Donatella Mandolini & Mauro Grigioni & Marco Marchetti, 2020. "Multi–Criteria–Decision–Analysis (MCDA) for the Horizon Scanning of Health Innovations an Application to COVID 19 Emergency," IJERPH, MDPI, vol. 17(21), pages 1-9, October.
    2. Pim P Valentijn & Fernando Pereira & Christina W Sterner & Hubertus J M Vrijhoef & Dirk Ruwaard & Jörgen Hegbrant & Giovanni F M Strippoli, 2019. "Validation of the Rainbow Model of Integrated Care Measurement Tools (RMIC-MTs) in renal care for patient and care providers," PLOS ONE, Public Library of Science, vol. 14(9), pages 1-21, September.
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