Quality-of-Care Standards in Adult Type 3 Intestinal Failure caused by benign disease: a European Society of Clinical Nutrition and Metabolism (ESPEN) Position Paper.

Journal

Clinical nutrition ESPEN
ISSN: 2405-4577
Titre abrégé: Clin Nutr ESPEN
Pays: England
ID NLM: 101654592

Informations de publication

Date de publication:
09 Aug 2024
Historique:
received: 11 07 2024
revised: 03 08 2024
accepted: 06 08 2024
medline: 12 8 2024
pubmed: 12 8 2024
entrez: 11 8 2024
Statut: aheadofprint

Résumé

Outcomes related to chronic intestinal failure (CIF) vary significantly within and between countries. While there are extensive European Society of Clinical Nutrition and Metabolism (ESPEN) guidelines on the delivery of optimal care in CIF, there are no international consensus recommendations on the structure or resources required, nor on the process and appropriate outcome measures for delivering such quality care in CIF. The aim of this position paper is therefore to devise ESPEN-endorsed, internationally agreed quality of care standards, covering the resources, systems and standards that centres should aim for in order to deliver optimal CIF care. Members of the Home Artificial Nutrition-CIF Special Interest Group of ESPEN proposed an initial set of quality-of-care standards which was submitted to voting amongst clinicians from international CIF centres using a modified Delphi process, with participants rating each proposed statement as 'essential', 'recommended' or 'not required'. Any statement receiving 80% of more 'not required' responses was excluded. All 30 proposed standards relating to the structure, 18 relating to the process and 16 to the outcome measures of CIF care were deemed to be essential or recommended in more than 80% of respondents. This is the first paper to determine and describe internationally-agreed quality of care standards in CIF, which are now aimed at forming the basis for all CIF teams to develop and monitor their service, while also informing policymakers and payers on the infrastructure required for the optimal approach to multi-disciplinary team CIF care delivery. The recording of standardised outcomes should also allow internal and external benchmarking of care delivery within and between CIF centres.

Sections du résumé

BACKGROUND BACKGROUND
Outcomes related to chronic intestinal failure (CIF) vary significantly within and between countries. While there are extensive European Society of Clinical Nutrition and Metabolism (ESPEN) guidelines on the delivery of optimal care in CIF, there are no international consensus recommendations on the structure or resources required, nor on the process and appropriate outcome measures for delivering such quality care in CIF.
AIM OBJECTIVE
The aim of this position paper is therefore to devise ESPEN-endorsed, internationally agreed quality of care standards, covering the resources, systems and standards that centres should aim for in order to deliver optimal CIF care.
METHODS METHODS
Members of the Home Artificial Nutrition-CIF Special Interest Group of ESPEN proposed an initial set of quality-of-care standards which was submitted to voting amongst clinicians from international CIF centres using a modified Delphi process, with participants rating each proposed statement as 'essential', 'recommended' or 'not required'. Any statement receiving 80% of more 'not required' responses was excluded.
RESULTS RESULTS
All 30 proposed standards relating to the structure, 18 relating to the process and 16 to the outcome measures of CIF care were deemed to be essential or recommended in more than 80% of respondents.
CONCLUSION CONCLUSIONS
This is the first paper to determine and describe internationally-agreed quality of care standards in CIF, which are now aimed at forming the basis for all CIF teams to develop and monitor their service, while also informing policymakers and payers on the infrastructure required for the optimal approach to multi-disciplinary team CIF care delivery. The recording of standardised outcomes should also allow internal and external benchmarking of care delivery within and between CIF centres.

Identifiants

DOI: 10.1016/j.clnesp.2024.08.001 PMID: 39128704
pubmed: 39128704
pii: S2405-4577(24)01272-5
doi: 10.1016/j.clnesp.2024.08.001
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Ltd.

Auteurs

Lal S (L)

National Intestinal Failure Reference Centre, Northern Care Alliance and University of Manchester, Manchester, Stott Lane, Salford. M6 8HD. U.K. Electronic address: simon.lal@nca.nhs.uk.

Soop M (S)

Department of IBD and Intestinal Failure Surgery, Karolinska University Hospital, SE 177 76 Stockholm, Sweden.

Cuerda C (C)

Departamento de Medicina, Universidad Complutense de Madrid, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

Jeppesen P (J)

Rigshospitalet, Department of Gastroenterology, Copenhagen, Denmark.

Joly F (J)

Department of Gastroenterology and Nutritional Support, Center for Intestinal Failure, Reference Centre of Rare Disease MarDI, AP-HP Beaujon Hospital, University of Paris Inserm UMR, 1149, Paris, France.

Lamprecht G (L)

Division of Gastroenterology and Endocrinology, Department of Medicine II, Rostock University Medical Center, Rostock, Germany.

Mundi M (M)

Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA.

Szczepanek K (S)

General and Oncology Surgery Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland.

Van Gossum A (V)

Medico-Surgical Department of Gastroenterology, Hˆopital Erasme, Free University of Brussels, Belgium.

Wanten G (W)

Intestinal Failure Unit, Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

Vanuytsel T (V)

Translational Research Center for Gastrointestinal Disorders, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.

Weimann A (W)

Department of General, Visceral and Oncological Surgery, St. George Hospital, Leipzig, Germany.

Pironi L (P)

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Centre for Chronic Intestinal Failure, IRCCS AOUBO, Bologna, Italy.

Classifications MeSH