Abstract
Issue/problem
Decision-making in hospitals is evolving from being opinionbased
to being evidence-based. Whilst clinical guidelines
provide evidence-based recommendations, evidence-based
practice needs to address the local structure, systems and time-frames. Clinical pathways are document-based tools that
provide a link between the best available evidence and clinical
practice.
Problem
During a meeting with the professional from all ‘A. Gemelli’
teaching hospital units involved in the care of stomach cancer
patients as well as primary care representatives, the Clinical
Governance Unit presented the project of developing a clinical
pathway for the care of stomach cancer patients.
Professionals were divided in three groups: a first group
analyzed the specific epidemiological context of stomach
cancer patients attending the hospital, a second group designed
on the basis of evidence and current practice the pathway
flowchart in a diagram that shows on vertical axis stages of care
and on orizonal axis the places of care and a third group
selected quality indicators useful for future audits.
After joint debates, the complete clinical pathway was reviewed
by the whole group of involved professionals.
Results
A report including the pathway flowchart of activities
articulated in clinical episodes and 28 indicators covering 5
quality dimensions was approved. Multidisciplinary team
meetings as well as joint surgeon/medical oncologist examinations
were introduced in hospital practice. Case management
and cooperation between hospital and primary care were
enhanced.
The use of hospital resource and the timing between the
different care stages as well as patients’ satisfaction resulted
improved. Preliminary results show also improvements in
clinical outcome measured.
Lessons
Clinical pathways are an effective instrument to decrease
undesired practice variability and improve clinician performance.
The early involvement of all professionals in the
development of clinical pathways is critical to theirs success.
The definition of quality indicators allows to evaluate and
monitor implemented clinical pathways.
Key messages
Clinical pathways providing evidence-based practice can
improve quality of care
The early involvement of all professionals is a key strategy
for clinical pathway development.
Lingua originale | English |
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pagine (da-a) | 341-342 |
Numero di pagine | 2 |
Rivista | European Journal of Public Health |
Volume | 25 (Suppl. 3) |
Stato di pubblicazione | Pubblicato - 2015 |
Evento | 8th European Public Health Conference “Health in Europe – from global to local policies, methods and practices” - Milano Durata: 14 ott 2015 → 17 ott 2015 |
Keywords
- Clinical pathway
- Healthcare quality
- Stomach cancer