The Effectiveness of Integrated Care Pathways for Adults and Children in Health Care Settings: A Systematic Review

2009 ◽  
Vol 7 (3) ◽  
pp. 80-129 ◽  
Author(s):  
Davina Allen ◽  
Elizabeth Gillen ◽  
Laura Rixson
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Integrated Care ◽  
Care Pathways ◽  
Health Care Settings ◽  
Integrated Care Pathways ◽  
Adults And Children

scholarly journals Integrated care pathways in neurosurgery: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255628
Author(s):  
Keng Siang Lee ◽  
Stefan Yordanov ◽  
Daniel Stubbs ◽  
Ellie Edlmann ◽  
Alexis Joannides ◽  
...  
Keyword(s):  
Systematic Review ◽  
Integrated Care ◽  
Performance Metrics ◽  
Positive Impact ◽  
Case Series ◽  
The United States ◽  
Control Group ◽  
Care Pathways ◽  
Patient Reported ◽  
Integrated Care Pathways

Introduction Integrated care pathways (ICPs) are a pre-defined framework of evidence based, multidisciplinary practice for specific patients. They have the potential to enhance continuity of care, patient safety, patient satisfaction, efficiency gains, teamwork and staff education. In order to inform the development of neurosurgical ICPs in the future, we performed a systematic review to aggregate examples of neurosurgical ICP, to consider their impact and design features that may be associated with their success. Methods Electronic databases MEDLINE, EMBASE, and CENTRAL were searched for relevant literature published from date of inception to July 2020. Primary studies reporting details of neurosurgical ICPs, across all pathologies and age groups were eligible for inclusion. Patient outcomes in each case were also recorded. Results Twenty-four studies were included in our final dataset, from the United States, United Kingdom, Italy, China, Korea, France, Netherlands and Switzerland, and a number of sub-specialties. 3 for cerebrospinal fluid diversion, 1 functional, 2 neurovascular, 1 neuro-oncology, 2 paediatric, 2 skull base, 10 spine, 1 for trauma, 2 miscellaneous (other craniotomies). All were single centre studies with no regional or national examples. Thirteen were cohort studies while 11 were case series which lacked a control group. Effectiveness was typically evaluated using hospital or professional performance metrics, such as length of stay (n = 11, 45.8%) or adverse events (n = 17, 70.8%) including readmission, surgical complications and mortality. Patient reported outcomes, including satisfaction, were evaluated infrequently (n = 3, 12.5%). All studies reported a positive impact. No study reported how the design of the ICP was informed by published literature or other methods Conclusions ICPs have been successfully developed across numerous neurosurgical sub-specialities. However, there is often a lack of clarity over their design and weaknesses in their evaluation, including an underrepresentation of the patient’s perspective.

Attitudes towards Integrated Care Pathways in the UK NHS: A Pilot Study in One UK NHS Trust

2005 ◽  
Vol 9 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Dianne Parker ◽  
Tanya Claridge ◽  
Gary Cook
Keyword(s):  
Health Care ◽  
Integrated Care ◽  
Health Care Professionals ◽  
Systematic Investigation ◽  
Care Practice ◽  
Care Pathways ◽  
Junior Staff ◽  
Positive Attitudes ◽  
Integrated Care Pathways ◽  
The Uk

Background: Integrated care pathways (ICPs) offer an increasingly common approach to the standardization and integration of health-care practice in hospitals. The questionnaire study reported here was the final phase in a systematic investigation of the attitudes of health-care professionals towards ICPs in one acute UK NHS Trust. Method: A total of 314 health-care professionals working in a medium-sized NHS hospital in the UK completed a survey questionnaire, representing 34% of those approached. Results: Ten dimensions of attitude to ICPs were uncovered. Junior staff had less positive attitudes than senior staff on all dimensions. Across all professional groups (doctors, nurses, professions allied to medicine), staff were more unhappy with the idea of ICPs than with the evidence they are based on or the quality of the documentation itself. Conclusions: The investigation provided information about how widespread the dislike of ICPs was in the Trust and details of what was giving rise to staff unease. This enabled the authors to make recommendations to the Trust about the future development and implementation of ICPs in the Trust. The most central of these was that investing time and effort in changing the presentation of ICPs will not meet with success until more fundamental aspects of staff unease have been addressed. Overall, respondents from this Trust felt uneasy about ICPs because they do not like the idea of being told what to do. Therefore, if the ICP development programme is to continue at this hospital and be successful, the hearts and minds of those expected to use ICPs must be won over.

The Care Process Organization Triangle: A Framework to Better Understand how Clinical Pathways Work

2007 ◽  
Vol 11 (2) ◽  
pp. 54-61 ◽  
Author(s):  
Kris Vanhaecht ◽  
Karel de Witte ◽  
Walter Sermeus
Keyword(s):  
Health Care ◽  
Integrated Care ◽  
Care Management ◽  
Clinical Pathways ◽  
Health Care Management ◽  
Care Process ◽  
Care Pathways ◽  
Patient Needs ◽  
Care Processes ◽  
Integrated Care Pathways

Clinical pathways, also known as care pathways or integrated care pathways, are used worldwide to make care processes transparent and organize care around patient needs. Although this is in international use, it is still unclear why pathways sometimes work and sometimes do not. To better understand how pathways work, there is a growing need for paradigms or organizing concepts. Different quality and health-care management gurus have developed frameworks to better understand how certain processes or methods work. This paper will provide an overview of several frameworks and integrate them into Donabedian's Structure–Process–Outcome configuration. In view of this configuration, the care process organization triangle was developed. In this paper, we will describe the three cornerstones of this triangle by integrating the literature on clinical pathways. The care process organization triangle is only one model, but as Deming described it: ‘Some models can be quite useful’.

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