Setting indicators for oncological clinical pathways: a 2-round Delphi method and face-to-face meeting

Abstract

Abstract Background An ongoing project, promoted by “Gruppo Italiano di Reti Oncologiche” (GIRO) network and coordinated by the “Istituto Superiore di Sanità”, aims to apply Value Based Healthcare (VBH) for evaluating the performance of oncological healthcare providers. In this framework, the aim of this study was to define a set of indicators for assessing the overall clinical pathway for patients with colorectal cancer receiving healthcare in one of the seven GIRO referral centers. Methods A 2-round Delphi study was conducted involving experts from GIRO centers. A list of preliminary indicators, identified from national and international agencies, was firstly evaluated according to four criteria (relevance, evidence-based, measurability, actionability) using a 5-point Likert scale. Indicators receiving ≥50% of judgements ≥3 in 3/4 criteria went to selection process of the second round. The second survey firstly asked whether the indicator was to be included in the final set and, if yes, it was then evaluated on a balancing criterion. Indicators receiving ≥75% of agreement for inclusion and ≥50% of judgements ≥3 for balancing were confirmed for the final set. During the face-to-face meeting, a subset of indicators was prioritized for a pilot collection. Results After 1st-round consultation, all the 34 indicators in the preliminary list passed to the 2nd-round and 32 (94%) of these were included in the final set (16 colon;16 rectum). During the face-to face meeting, critical issues highlighted during the process (e.g. events occurring outside the referral center) were discussed and 16 (50%) indicators were prioritized for the pilot collection (8 colon;8 rectum). Conclusions Evaluating the overall clinical pathway for oncological patients is very important for achieving high-quality healthcare. Enhancing collaboration and networking among oncological referral centers is a main tool for the continuous improvement of healthcare outcomes in a VBH perspective. Key messages Evaluating the overall clinical pathway for oncological patients is very important for achieving high-quality healthcare. Enhancing collaboration and networking among oncological referral centers is a main tool for the continuous improvement of healthcare outcomes in a VBH perspective.