Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Urogynecology Journal
Published in: International Urogynecology Journal 1/2019

Open Access 01-01-2019 | Original Article

Development of quality outcome indicators to improve the quality of urinary and faecal continence care

Authors: Adrian Wagg, Dianne Gove, Kai Leichsenring, Joan Ostaszkiewicz

Published in: International Urogynecology Journal | Issue 1/2019

Login to get access

Abstract

Introduction and hypothesis

Despite 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.

Methods

An 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.

Results

The 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.

Conclusions

The 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.
Appendix
Available only for authorised users
Literature
1.
Irwin D, Kopp ZS, Agatep B, Milsom I, Abrams P. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int. 2011;108(7):1132–8.CrossRef
2.
Coyne K, Sexton CC, Thompson CL, et al. The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study. BJU Int. 2009;104(3):352–60.CrossRef
3.
Ditah I, Devaki P, Luma HN, et al. Prevalence, trends, and risk factors for fecal incontinence in United States adults, 2005-2010. Clin Gastroenterol Hepatol. 2014;12(4):636–43; e1-2.CrossRef
4.
Charalambous S, Trantafylidis A. Impact of urinary incontinence on quality of life. Pelviperineology. 2009;28:51-3.
5.
Lucas M, Bedretdinova D, Bosch JLHR, et al. Guidelines on urinary incontinence. Arnhem: European Association of Urology; 2003.
6.
Abrams P, Cardozo L, Wagg A, Wein A. Incontinence, 6th edition. 2017, Tokyo: International Consultation on Incontinence.
7.
Wagg A, Potter J, Peel P, Irwin P, Lowe D, Pearson M. National audit of continence care for older people: management of urinary incontinence. Age Ageing. 2008;37(1):39–44.CrossRef
8.
International Organization for Standardization.Absorbent incontinence aids for urine and/or faeces. Geneva: International Organization for Standardization; 2017.
9.
Wagg A, Duckett J, McClurg D, Harari D, Lowe D. To what extent are national guidelines for the management of urinary incontinence in women adhered? Data from a national audit. BJOG. 2011;118(13):1592-600.CrossRef
10.
Foust-Wright C, Wissig S, Stowell C, et al. Development of a core set of outcome measures for OAB treatment. Int Urogynecol J 2017;28(12):1785–93.CrossRef
11.
Fonda D, Abrams P. Cure sometimes, help always—a "continence paradigm" for all ages and conditions. Neurourol Urodynam. 2006;25(3):290–2.CrossRef
12.
The Secretariat. Multisectoral action for a life course approach to healthy ageing: draft global strategy and plan of action on ageing and health. Geneva: World Health Organization, 2016.
13.
Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.CrossRef
14.
15.
16.
Brown P, Billings J, Wagg A, Potter J, et al. Is it possible to measure what truly matters? The paradox of clinical audit in developing continence service standards for older people. Patient. 2010;3(1):11–23.CrossRef
17.
Donabedian A. An introduction to quality assurance in health care. New York: Oxford University Press; 2003.
18.
Toozs-Hobson P, Devani P, Pick J, Moran PA, Assassa P, Burton C. Does age affect the outcome of suburethral tape surgery? The importance of national registries in answering bigger questions. Int Urogynecol J. 2016;27(10):1541–5.CrossRef
19.
Mian S, Wagg A, Irwin P, Lowe D, Potter J, Pearson M. National audit of continence care: laying the foundation. J Eval Clin Pract. 2005;11(6):533–43.CrossRef
Metadata
Title
Development of quality outcome indicators to improve the quality of urinary and faecal continence care
Authors
Adrian Wagg
Dianne Gove
Kai Leichsenring
Joan Ostaszkiewicz
Publication date
01-01-2019
Publisher
Springer International Publishing
Published in
International Urogynecology Journal / Issue 1/2019
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-018-3768-2

Other articles of this Issue 1/2019

International Urogynecology Journal 1/2019 Go to the issue

Original Article

Reliability and validity of the Tigrigna version of the Pelvic Floor Distress Inventory–Short Form 20 (PFDI-20) and Pelvic Floor Impact Questionnaire-7 (PFIQ-7)

Review Article

Methods of assessing and recording bladder sensation: a review of the literature

Original Article

Should I stay or should I go? A qualitative study exploring participation in a urology clinical trial

Original Article

Polish translation and validation of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR)

Original Article

Pilot in vitro and in vivo study on a mouse model to evaluate the safety of transcutaneous low-frequency electrical nerve stimulation on cervical cancer patients

Original Article

The Female Genital Self-Image Scale (FGSIS): cross-cultural adaptation and validation of psychometric properties within a Turkish population