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Abstract
Introduction and hypothesisDespite the range of treatment options available, relatively few people with incontinence find a total cure. The importance of daily management with toileting and containment cannot be underestimated. To our knowledge, there are no outcome measures to benchmark good care. The aim of this study was to create a set of key performance indicators (KPIs) to measure outcomes for toileting and containment.MethodsAn expert panel (EP) defined a set of KPIs using evidence from a scoping review, stakeholder engagement, and expert consensus. Peer reviewed articles, high-quality grey literature and international and national standards were reviewed to identify existing measures for management. These findings were augmented by an exercise involving patients, caregivers, nurses, clinicians, payers, policy makers and care providers to prioritise the findings and identify additional areas of interest.ResultsThe final set of 14 KPIs includes quality indicators of process and outcome for those managed with a toileting and containment strategy and is relevant for both care-independent and -dependent persons. Rates of assessment, days waiting for specialist assessment, rates of return to work and those rating their quality of life as good or acceptable are captured. An indicator of well-being for caregivers and the economic costs of poor care are also defined.ConclusionsThe set of KPIs to measure outcomes from toileting and containment strategies describes the components of each to encourage integration into existing quality frameworks. Each KPI has been refined and detailed to encourage this. If implemented, resulting benchmarking data will facilitate care quality improvement and inform value-based care procurement and provision of toileting and containment strategies.
Highlights
Introduction and hypothesisDespite the range of treatment options available, relatively few people with incontinence find a total cure
This project was undertaken to complement continence-related key performance indicators (KPIs) by identifying and defining a set of indicators applicable to people with bladder and bowel problems who manage their care with a combination of toileting and containment with the intent of attaining contained, social continence [11]
A total of 158 potential KPI titles were identified from the full review of 89 academic and grey literature sources (Supplementary Fig. A)
Summary
Introduction and hypothesisDespite the range of treatment options available, relatively few people with incontinence find a total cure. The prevalence of fecal incontinence (FI) among community dwelling adults in the USA was recently estimated at 8.39%, with FI more common in women with UI [3] The prevalence of both UI [1] and FI [3] increases with age. With increased attention to value-based healthcare, a suite of outcome measures for overactive bladder has been developed for incorporation into administrative data sets [10] This project was undertaken to complement continence-related key performance indicators (KPIs) by identifying and defining a set of indicators applicable to people with bladder and bowel problems who manage their care with a combination of toileting and containment with the intent of attaining contained, social continence [11]
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