Guidelines and clinical pathways. Is there really a difference?

Simó, Manuel Romero; Aledo, Víctor Soria; López, Pedro Ruiz; Cuéllar, Elías Rodríguez; Albasini, José Luis Aguayo

doi:10.1016/s2173-5077(10)70011-9

Cited by 2 publications

(1 citation statement)

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“…Outcomes research is an essential part of the quality control process, and quality indicators of medical performance have been defined by consensus in order to determine the quality of care in a measurable way [16], [17]. In wildlife medicine, some clinical practice guidelines have been published which deal with welfare rehabilitation standards [18] and pre-release health screening protocols [19] but no quality indicators of the rehabilitation process have been defined.…”

Section: Introductionmentioning

confidence: 99%

Final Disposition and Quality Auditing of the Rehabilitation Process in Wild Raptors Admitted to a Wildlife Rehabilitation Centre in Catalonia, Spain, during a Twelve Year Period (1995–2007)

2013

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BackgroundVariability in reporting and classification methods in previous published data of the final dispositions in the rehabilitation of wild raptors makes use of this data limited in trying to audit the quality of the rehabilitation process. Crude as well as stratified disposition rates are needed if quality auditing of the rehabilitation process is to be adequately performed.MethodologyFinal dispositions of 6221 hospitalized wild raptors admitted at a wildlife rehabilitation centre (WRC) of Catalonia during 1995–2007 were analyzed. These dispositions were calculated as the euthanasia (Er), unassisted mortality (Mr), release (Rr) and captivity rates (Cr)., time to death (Td) for dead and euthanized raptors, and length of stay for released (Tr) raptors was estimated. Stratified analyses by main causes of admission and clinical signs were performed.ResultsThe disposition for the total population were: Er = 30.6%, Mr = 19.1%, Rr = 47.2%, and Cr = 3%. By main causes of admission, Er was higher in the trauma category (34.2%), whereas Mr was found similar between trauma (37.4%) and non-trauma categories (34.8%). The highest Rr was observed for the orphaned group (77.9%). Furthermore, Cr was low in all the categories (<4%). By clinical signs, the highest Er was found in animals suffering musculoskeletal (37.9%) or skin (32.3%) lesions; Mr was high in infectious/parasitic diseases (66.7%) and in case of neurological symptoms (64.5%). The euthanized birds had a median Td = 1 day (P10 = 0-P90 = 59) for both trauma and non-trauma categories, and Td = 36 days for the orphaned young group (P10 = 0; P90 = 596). The median Td in the unassisted dead birds was 2 days for all the categories (P10 = 0-P90 = 31). Finally, the median Tr in the centre was variable among categories.Conclusions/SignificanceReporting of final dispositions in wildlife rehabilitation should include the crude and stratified rates (Er, Mr, Rr, and Cr), by causes and clinical presentation, as well as Td and Tr, to allow meaningful auditing of the rehabilitation process quality.

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Section: Introductionmentioning

confidence: 99%