Defining pathways

Bleser, Leentje De; Depreitere, Roeland; WAELE, KATRIJN DE; Vanhaecht, Kris; VLAYEN, JOAN; Sermeus, Walter

doi:10.1111/j.1365-2934.2006.00702.x

Cited by 337 publications

(293 citation statements)

References 20 publications

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“…CPs are generally accepted as an effective quality system (De Bleser et al 2006;Ronellenfitsch et al 2008;Vanhaecht et al 2006), and the present study corresponds with this as the CP was conceptualized, among other ways, as an instrument for patient safety. Other authors have highlighted that CP can support the implementation of national and local guidelines into clinical practice and help care professionals to keep in touch with the latest scientific evidence (Currie and Harvey, 2000;Ronellenfitsch et al 2008).…”

Section: Quality Of Carementioning

confidence: 60%

See 1 more Smart Citation

Intensive care nurses’ conceptions of a critical pathway in caring for aortic-surgery patients: A phenomenographic study

Bjurling-Sjöberg

Engström

Lyckner

et al. 2013

Intensive and Critical Care Nursing

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Intensive care nurses' conceptions of a critical pathway in caring for aortic-surgery patients: a phenomenographic study. Intensive & Critical SUMMARYThe aim of the present study was to identify and describe intensive care nurses' different conceptions of a critical pathway in caring for patients that have undergone aortic-surgery.Individual semi-structured interviews with eight specialist registered nurses at a Swedish intensive care unit were conducted and phenomenographically analysed. Three descriptive categories, with a total of five sub-categories, constituted the outcome-space of how the pathway was conceived of in caring: as a guide open to individual patients needs (clinical judgment governs caring and patient autonomy governs caring), as an instrument to promote patient safety (a source of knowledge, a planning tool and a reference standard) and as a source of support for professional confidence.In accordance with current literature, the nurses in the present study identified a number of advantages in applying the pathway in caring even if they were also conscious that the use of a pathway can give rise to unreflective standardization. The nurses' conceptions indicate that the pathway prescribed for managing patients who have undergone aortic surgery is supportive and facilitates patient safety without jeopardizing respect for the patient's individual care needs. This insight may be used to influence a thoughtful dialogue about the practice of pathways in intensive care.

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Section: Quality Of Carementioning

confidence: 60%

“…It aims to improve quality of care, reduce risks, enhance patient satisfaction and enhance efficiency (De Bleser et al 2006). …”

Section: Introductionmentioning

confidence: 99%

Intensive care nurses’ conceptions of a critical pathway in caring for aortic-surgery patients: A phenomenographic study

Bjurling-Sjöberg

Engström

Lyckner

et al. 2013

Intensive and Critical Care Nursing

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“…I PDTA sono nati a metà degli anni Ottanta a Boston, nel New England Medical Center, e da lì si sono diffusi a ondate successive prima in Nord America (in Canada come CareMaps), poi nel mondo anglosassone e del Commonwealth, quindi in Europa e Giappone e infine dopo il 2000 anche in aree sudamericane e del sud-est asiatico [8] [11] hanno raccolto 84 diverse definizioni di Clinical Pathway (CP) in 82 dei 263 articoli selezionati con la metodologia della "concept analysis". Gli Autori sostengono che nessuno dei 19 termini ulteriormente selezionati contiene totalmente le 2 dimensioni considerate critiche (contenuto e cambiamento), obiettivo che è avvicinato da "linee guida" ma probabilmente potrebbe essere meglio espresso da "processo" o "intervento".…”

Section: Percorsi Diagnostico-terapeutici Assistenziali (Pdta)unclassified

PDTA e Medicina di Laboratorio

Cappelletti

2017

Riv Ital Med Lab

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Riassunto I Percorsi Diagnostico-Terapeutici Assistenziali (PDTA) sono definiti come interventi complessi che descrivono i processi delle decisioni cliniche e dell'organizzazione di cura di un ben definito gruppo di pazienti, in un definito periodo di tempo. Costituiscono i pilastri per la realizzazione della "centralità del paziente" sulla base delle evidenze scientifiche. I PDTA possono essere definiti come la contestualizzazione di una o più linee guida, relative a una patologia o problematica clinica, nella specifica realtà organizzativa di un'Azienda sanitaria. I PDTA sono ampiamente utilizzati ed esistono evidenze, seppur narrative, della loro efficacia. I principali problemi sono la personalizzazione e l'innovazione. La Medicina di Laboratorio deve fare la sua parte nella costruzione dei PDTA, partecipando ai gruppi multidisciplinari e multiprofessionali, con attenzione ai test pivot, al loro uso e alla loro interpretazione; alla qualità delle linee guida scelte; al dettaglio dei protocolli operativi che sostanziano il percorso; agli aspetti "interni" che determinano (performance analitica) o aumentano (total testing process) la qualità della risposta; alla verifica continua dell'appropriatezza e adeguatezza dei marcatori utilizzati e all'audit dell'effectiveness del PDTA. Si tratta di uno degli aspetti più alti di "lavoro all'interfaccia", nelle aree di pre-pre e post-post testing process, ove l'affidabilità analitica e il suo rapporto con la realtà clinica e i suoi esiti sono immediatamente percepibili. Centralità del paziente e PDTA La "centralità del paziente" [1] è divenuta un tema cruciale della Medicina occidentale, anche per la presa d'atto delle iniquità, frammentazioni, sovrapposizioni e discontinuità che caratterizzano molto spesso l'erogazione dei servizi sanitari (effetto silo) e delle loro conseguenze sugli esiti Parole chiave Medicina di Laboratorio

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“…The terms Critical Pathway, Clinical Pathway or Integrated Care Pathway are used for this concept synonymously. Some authors try to define them differently [12,13]. But until now, no real consensus was found in the scientific community.…”

Section: The Clinical Pathwaymentioning

confidence: 99%

“…The European Pathway Association defines a CPs as: "Clinical pathways are a methodology for the mutual decision making and organization of care for a well-defined group of patients during a well-defined period. Characteristics of care pathways are: "An explicit statement of the goals and key elements of care based on evidence, best practice, and patient expectations; The facilitation of the communication, coordination of roles, and sequencing the activities of the multidisciplinary care team, patients and their relatives; The documentation, monitoring, and evaluation of variances and outcomes; And the identification of the appropriate resources" [12]. The aim of a care pathway is to enhance the quality of care by improving patient outcomes, and promoting patient safety, increasing patient satisfaction, and optimizing the use of resources.…”

Section: The Clinical Pathwaymentioning

confidence: 99%

From Clinical Practice Guideline to Clinical Pathway –Issues of Reference Model-Based Approach

Schlieter¹,

Esswein²

2010

IFIP Advances in Information and Communication Technology

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Abstract. Health care systems are facing new challenges such as the aging population, the increasing amount of chronicle diseases and the rapid development of medical technologies. The increasing of the related health care costs lead to the limits of affordability of health care systems. Building Health networks and standardization of clinical processes are the main trend facing these challenges. Actually, the main instrument for documentation and managing of clinical processes are Clinical Pathways (CPs). They allow to transfer evident knowledge in practice and they are the central point of clinical quality management. In contrast, Clinical Practice Guidelines (CPGs) aggregate the evident medical knowledge in a compact form to support physicians in their practice. In the paper analyze the model-driven development of CP for a health network. Therefore, we work out problems of integration. Finally, the paper shows aspect for a model-based integration of CPGs in CPs. These findings are proofed with the help of the documentation of the regional stroke-network called SOS-NET.

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Defining pathways

Cited by 337 publications

References 20 publications

Intensive care nurses’ conceptions of a critical pathway in caring for aortic-surgery patients: A phenomenographic study

Intensive care nurses’ conceptions of a critical pathway in caring for aortic-surgery patients: A phenomenographic study

PDTA e Medicina di Laboratorio

From Clinical Practice Guideline to Clinical Pathway –Issues of Reference Model-Based Approach

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