Clinical pathways as a healthcare tool: design, implementation and assessment of a clinical pathway for lower-extremity deep venous thrombosis

Verdú, Asunción Martínez; Lopez, Pat; Gil, Vicenç; Martín-Hidalgo, Antonia; Castaño, João

doi:10.1136/qshc.2007.023218

Cited by 9 publications

(3 citation statements)

References 33 publications

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“…Care/clinical pathways have also become a common source of guidance for clinicians, but the terms used to describe a clinical pathway number more than 80 (Kinsman et al. 2010), where the goal of such a pathway is to base the care of the patient on the best available evidence and establish an institutional commitment of care for a particular diagnosis (Verdu et al. 2009).…”

Section: Resultsmentioning

confidence: 99%

End-of-life care in acute hospitals: an integrative literature review

Bloomer¹,

Moss²,

Cross³

2011

Journal of Nursing and Healthcare of Chronic Illness

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End-of-life care in acute hospitals: an integrative literature review Aim. To explore and define the current status of published literature related to endof-life care in the acute hospital setting. Background. Chronic illness is now the leading cause of death in developed countries because the population is and the advances in health care delivery. In Australia, two-third of people with chronic illness who die is inpatient in an acute hospital. Whilst most of the attention regarding end-of-life care and dying has focused on palliative care settings, there is a need to consider those dying outside of specialist palliative care settings. Design. Integrative literature review. Methods. Using an integrative approach, electronic searches of selected databases were undertaken, using comprehensive search terms. Secondary sources were also identified through the reference lists of retrieved literature. Results. The literature review identified a lack of high-quality scientific evidence to direct end-of-life care as delivered in the acute (non-palliative care) sector. From the literature available, five core themes/issues were generated to reflect the literature. Conclusions. There is a need for research to investigate end-of-life care in the acute hospital setting. Care pathways are in use to varying degrees without validation, but implementation alone does not ensure quality end-of-life care. Cultural factors can impede/impact practice and the ability of clinicians to recognise 'active dying' has been shown to be problematic, delaying the transition to end-of-life care. Relevance to clinical practice. Given that the majority of deaths in Australia occur in acute hospital settings, clinicians should be delivering expert life-sustaining acute care and also quality end-of-life care.

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Section: Resultsmentioning

confidence: 99%

End-of-life care in acute hospitals: an integrative literature review

Bloomer¹,

Moss²,

Cross³

2011

Journal of Nursing and Healthcare of Chronic Illness

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“…However, there is little literature available regarding the clinical pathway management in infectious diseases. [11][12][13][14][15] Through this study, the implementation of clinical pathways in varicella, measles, rubella, scarlet fever and acute bacillary dysentery strongly suggests their application is of great practical significance as evidenced by the decrease in hospital costs and average length of stay.…”

Section: Discussionmentioning

confidence: 99%

Study of the Application of Clinical Pathways in Varicella, Acute Bacillary Dysentery, Measles, Scarlet Fever, and Rubella

Xu¹,

Qin²,

Zhao³

et al. 2014

N A J Med Sci

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In order to explore the clinical pathways that fit the actual situation of our country and department of infectious diseases, an analysis was performed to evaluate the effectiveness of clinical pathways for varicella, acute bacillary dysentery, measles, scarlet fever and rubella when compared with traditional standard medical care. Using a retrospective comparative study design, varicella, acute bacillary dysentery, measles, scarlet fever and rubella patients who were managed on a clinical pathway (clinical pathway group) were compared with a retrospective group of patients who received traditional medical care (control group) prior to the pathway's implementation. The following outcomes were measured: length of hospital stay, hospitalization costs. There was a significant reduction in the median hospitalization costs in the clinical pathway group patients in all five infectious diseases (P<0.05). The clinical pathway group's length of hospital stay for varicella, measles, acute bacillary dysentery and rubella were significantly shorter than the control group (P<0.05). The implementation of clinical pathways in varicella, acute bacillary dysentery, measles, scarlet fever and rubella might contribute to better quality of care and cost-effectiveness.

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“…To this end, clinical pathways will become increasingly important in the context of case tariff fees as a part of the International Statistical Classification of Diseases and Related Health Problems (ICD) for inpatient hospital services. These pathways will contribute towards shortening the period of hospitalisation ( Hommel et al , 2008 ; Ishiguro et al , 2008 ), reducing costs ( Verdú et al , 2009 ; Barbieri et al , 2009 ; Rook 1998 ; Velasco et al , 1996 ) and increasing the quality of the services provided ( Schwarzbach et al , 2010 ; Andriessen et al , 2009 ; Feuth & Claes, 2008 ). A generally valid definition of “clinical pathway” exists neither in the USA, nor in Australia, nor in Europe.…”

Section: Introductionmentioning

confidence: 99%

Clinical Pathways as Instruments for Risk and Cost Management in Hospitals - A Discussion Paper

Romeyke

Stummer²

2012

GJHS

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Introduction:The distinctive characteristics of the German health system are medical progress and financial pressure—and this is especially true of the hospitals. These challenges must be met by strategic management instruments for quality assurance, and by reducing costs.Purpose:This article presents the instrument “clinical pathway” (also known as “clinical treatment pathway”) and describes the possibilities it offers, both for quality assurance and risk management, and for cost reduction. The clinical pathway presented here will be that for “multimodal pain therapy”, as used in the context of acute inpatient care in Germany.Methods:A general presentation of the risks in hospital is followed by consideration of the risks associated with core processes. A comprehensive total cost analysis is performed for those patients who meet the pathway entry criteria and who fulfil the requirements for the structure of care provided within multimodal pain therapy.Discussion and Conclusion:Multimodal pain therapy places high demands on the structural, procedural and outcome quality of the medical, nursing and therapeutic services provided, and these demands are reflected in high costs for the provision of this care. The treatment process involves many different professional groups. These complex interfaces can potentially generate risks, which can lead to the possibility of legal liability. A clinical pathway must structure the core process and then combine elements of quality assurance in order to optimise patient care and minimise risk. The examination of costs reveals significant potential savings (patients with clinical pathway: EUR 3086±212; patients without clinical pathway: EUR 3774±460; Mann-Whitney U test; p<0.001). For the managers of a hospital, the clinical pathway represents a strategic management instrument that can serve for continual cost control and cost reduction, and can contribute in the form of quality assurance towards a transparent provision of services.

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Clinical pathways as a healthcare tool: design, implementation and assessment of a clinical pathway for lower-extremity deep venous thrombosis

Abstract: The implementation of a lower-extremity DVT clinical pathway in our institution has help to reduce hospitalisation costs, due to a decreased length of hospital stay.

Cited by 9 publications

References 33 publications

End-of-life care in acute hospitals: an integrative literature review

End-of-life care in acute hospitals: an integrative literature review

Study of the Application of Clinical Pathways in Varicella, Acute Bacillary Dysentery, Measles, Scarlet Fever, and Rubella

Clinical Pathways as Instruments for Risk and Cost Management in Hospitals - A Discussion Paper

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