Classifying clinical pathways De Bleser, Leentje; Vlayen, Joan; Vanhaecht, Kris ...
Studies in health technology and informatics,
2004, Letnik:
110
Journal Article
Recenzirano
Clinical pathways are commonly developed for homogenous patient groups. We were wondering if the traditional patient classification systems could be used for classifying clinical pathways.
To examine ...the utility of patient classification systems for clinical pathways, a sample of 13 clinical pathways was analyzed, involving a total of 412 patients. Three classification systems were tested: International Classification of Diseases, Ninth Revision (ICD9-CM), Clinical Coding System (CCS) data and All-Patient Redefined Diagnosis Related Groups (APR-DRG).
Categorization with ICD9-CM and CCS shows rather wide variation. However, when restricting for the principal codes, CCS classification shows an almost homogeneous relationship with clinical pathways. APR-DRG's are already corrected for secondary procedures and are difficult to assess. Categorization with the Risk Of Mortality (ROM) is more homogeneous than with the Severity Of Illness (SOI).
Patient groups in clinical pathways are rather heterogeneous. When restricting for the principal procedures, the strongest relationship seems to exist between clinical pathways and CCS. Further research is needed to refine this relationship.
Occupational health services face important changes as a result of changes in work environment, changing health and safety concepts, and legislation. To ensure good quality at a good price, it is ...important to control the processes in occupational health services. The concept of "prevention pathways" is presented for the management of occupational health services. The model is based on the critical pathway concept. The approach is illustrated by means of a case study performed in a Belgian occupational health service. A prevention pathway for the evaluation of chemical risks at the workplace was constructed. The prevention pathway methodology revealed inefficiencies and quality problems in the current practice of chemical risk assessment and biomonitoring. The case shows how prevention pathways can be used to pilot the members of a multidisciplinary team by focusing on a specific occupational risk.
One collaborative research project led by nurses was the WISECARE (Workflow Information Systems for European Nursing Care) project, which was funded by the European Commission and aimed to improve ...cancer nursing practice and ultimately patient outcomes through the integration and utilization of state of the art information technology. Addresses the advantages and disadvantages associated with collaboration, using the WISECARE project as an example. (Original abstract - amended)
Collaboration in cancer nursing practice Kearney, Nora; Miller, Morven; Sermeus, Walter ...
Journal of clinical nursing,
20/May , Letnik:
9, Številka:
3
Journal Article
Recenzirano
• Although nursing represents around half of Europe’s healthcare budgets, its impact is seldom evaluated. However, given the current era of cost‐containment, nursing must prove the value of its ...clinical effectiveness.
• Through European collaboration, the WISECARE project is working towards identifying the unique contribution of cancer nursing.
• This paper will explain the rationale and goals of the WISECARE project and demonstrate the collaborative processes involved within such a project.
• The latest results of the project will be presented to prove the value of collaboration in ensuring the development of European standards of nursing care.
Clinical Pathways in Europe：an overview Massimiliano Panella; Kris Vanhaecht
Journal of Japanese Society for Clinical Pathway,
2007, Letnik:
9, Številka:
3
Journal Article
In health care, managers become aware of the importance of providing good-quality care. To deal with the changing circumstances, 'new public management' is introduced in mental health care. One ...example is the growing popularity of the SWOT (strengths, weaknesses, opportunities and threats) analysis. In this paper, the use of a SWOT analysis as a strategic management tool in mental health care is studied. Qualitative research, using a SWOT document for questioning employees about the care programmes in a regional psychiatric hospital, is presented. In total, 186 SWOT documents were distributed; 168 were completed by 28 participants. For child and youth psychiatry a total SWOT was made for eight pathology groups; for adult psychiatry eight groups; and for elderly psychiatry seven pathology groups. This resulted in some interesting findings about the different care programmes the hospital offers for their patients. But this does not mean that the methodology is impeccable. For instance, because of the absence of clinical pathways it was harder to interpret the results. A critical discussion about the methodology is presented, as well as a SWOT analysis about the use of a SWOT analysis in mental health-care organizations. A SWOT analysis can be a very useful strategic management instrument if one takes into account the methodology and the mostly uncertain environmental factors.
The goal of reducing the length of a patient's hospital stay after orthopaedic surgery has recently gained much interest from surgeons and hospital administrators. The influence of hospital stay ...reduction on qualitative outcome is not always documented. The purpose of this study was to investigate this relationship in more detail. We report our experience with patients undergoing total knee arthroplasty. In 2000, an in-hospital clinical pathway for patients undergoing total knee arthroplasty was instituted at the University Hospitals Pellenberg, Belgium. We evaluated this pathway in 103 patients by using a pre-experimental, interrupted, time-series design. This pathway significantly decreased length of stay by 33% without negatively affecting functional outcomes during hospitalisation. In further research also the long-term effects have to be studied.
