Clinical pathway for patients with cerebral lesions: A lean way to improve quality and efficiency [Poster walk]

Issue Evidence-based decision-making has become the leading framework for hospital management. Clinical pathways are evidence-based tools supporting healthcare delivery by linking best scientific evidence and clinical practice. Description of the problem ‘‘Fondazione A. Gemelli‘‘ hospital developed several clinical pathways to pursue a continuous healthcare quality improvement. A new one for patients with cerebral lesion has been recently approved to reduce waiting times, hospital length of stay and to offer a leaner care. All professionals involved in the care of these patients leaded by the Clinical Governance Directorate cooperated for the project. A flow-chart pathway has been designed on the basis of evidence and current practice in a diagram showing on the vertical axis the stages of care and on the horizontal axis the places of care. Health professionals were divided into three teams carrying out: analysis of the epidemiological context of patients with cerebral lesion attending the hospital, design of the flow-chart pathway and definition of quality indicators useful for healthcare monitoring. After joint meetings and debates of the working groups, the whole clinical pathway was approved by all of the involved professionals.Results A report with flowchart, description of the pathway activities and 15 indicators covering 5 quality dimensions was drawn up approved and shared by the stakeholders. Tumor Boards were introduced in hospital practice and multidisciplinary approach in medical management of patients was strengthened. Case management and integration between primary and secondary care were also implemented. Healthcare efficiency, patients’ satisfaction and outcomes were improved. Lessons Clinical Pathway is a valid instrument for addressing health needs and resources and to improve efficiency in terms of timing and resources. Commitment of all professionals involved in the pathway of care is indispensable.