One-day diagnosis for hepatobiliary and pancreatic lesions: An innovative patient-centered care pathway organization

Pessaux, Patrick; Faucher, V.; Cuny, Reinhard H.; Stephan, Michael; Klein, François; González, C.; Blanes, S.; Léost, E.; Delattre, Bastien; Lugiez, C.

doi:10.1016/j.jviscsurg.2018.02.005

Cited by 8 publications

(4 citation statements)

References 8 publications

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“…The “1DD care pathway” study arm, whose operational description has been reported [ 8 ], included prospective data collection for all patients consecutively managed between January 2017 and April 2019. The second arm was a retrospective control group, referred to as the “conventional care pathway”, which included all consecutive patients taken care of between November 2014 and November 2015.…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of an Innovative Care Pathway in the Diagnostic and Therapeutic Management of Hepatobiliary and Pancreatic Pathologies: “One-Day Diagnosis”

Cherkaoui

Seeliger

Faucher

et al. 2022

JPM

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“One-Day Diagnosis” (1DD) for hepatobiliary and pancreatic (HBP) diseases is an innovative care pathway that combines, on the same day, surgical consultation, medical imaging, anesthesia, diagnosis announcement, and therapeutic support consultations. The objective was to evaluate the length of the 1DD care pathway compared to a conventional one. The prospective “1DD care pathway” arm included 330 consecutive patients (January 2017–April 2019) vs. 152 (November 2014–November 2015) in the retrospective “conventional” one. In the 1DD group, diagnosis was made on the same day in 83% of consultations vs. 68.4% (p = 0.0005). Although there was no difference in overall time to diagnosis, diagnostic and therapeutic management was faster in the 1DD group (1 day vs. 15 days, p < 0.0004). In addition, 77% of patients who benefited from 1DD were very satisfied with their treatment overall. The mean cost of the 1DD consultation was EUR 176.8 +/− 149 (range: 50–546). The median cost of the overall program was similar (EUR 584 vs. EUR 563, p = 0.67). As an organizational innovation, the 1DD for HBP pathologies is a promising care pathway that optimizes diagnostic and therapeutic management, without creating medical overconsumption or additional costs. Given patient satisfaction, this model should be generalized to optimize cancer care by adapting it to the constraints of different healthcare structures.

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Section: Methodsmentioning

confidence: 99%

“…In this context, the organizational innovation of “One-Day Diagnosis” (1DD) for hepatobiliary and pancreatic (HBP) diseases was initiated [ 8 ]. The rationale of the study was to bring together all actors and resources needed for diagnosis and initiation of the treatment pathway within one day.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an Innovative Care Pathway in the Diagnostic and Therapeutic Management of Hepatobiliary and Pancreatic Pathologies: “One-Day Diagnosis”

Cherkaoui

Seeliger

Faucher

et al. 2022

JPM

View full text Add to dashboard Cite

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“…The benefits of care pathways include reduced hospital stays, maximized patient outcomes, increased patient satisfaction, reduced risk, and appropriately used resources. [23][24][25] According to Evans et al, 26 the positive impact of care pathways correlates with the involvement of health care providers and managers. Care pathways can impact the care process and collaboration among health care providers.…”

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confidence: 99%

The Effect of Care Pathways on Coronary Care Nurses: A Preliminary Study

Daghash

Abdullah

Ismail

2022

Quality Management in Health Care

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Background and Objectives: A care pathway is a structured care plan based on best clinical practice for a particular patient group. It reorganizes a complex process by providing structured, standardized care and supportive multidisciplinary teamwork. Although care pathways are used worldwide, the impact and benefit of a care pathway for coronary care practices have been minimally debated. This preliminary study aimed to examine the effect of a care pathway on the autonomy, teamwork, and burnout levels among coronary care nurses in a tertiary hospital. Methods: A preliminary study was conducted using a pre/posttest one-group quasi-experimental design. A self-administered questionnaire was provided to 37 registered nurses from the cardiac ward of a tertiary hospital. The care pathway was developed on the basis of the current literature, local guidelines, and expert panel advice. The autonomy, teamwork, and burnout levels at the beginning and 4 months after disseminating the care pathway were measured. Implementing the care pathway included educational sessions, training in using the care pathway, and site visits to monitor nursing practices. Results: Most of the respondents were female (94.6%; n = 35), the median age of the respondents was 26.5 years (interquartile range [IQR] = 23-31), and the median length of the clinical experience was 4 years (IQR = 2-8). A statistically significant reduction in the mean burnout score was observed (mean of 58.12 vs 52.69, P < .05). A slight improvement in autonomy level was found, although it was not statistically significant. No statistically significant improvement was found in the teamwork levels. Conclusion: The care pathway was associated with reduced nurse burnout. The results showed a slight improvement in autonomy level among coronary care nurses after implementing the care pathway. From a practical viewpoint, the current study can help policy makers and managers reduce burnout. This study highlights the importance of using care pathways as a tool to reorganize the care process and improve the working environment. Managers must support nursing decisions and provide continuous education to enhance nurses' autonomy, which may increase understanding of respective roles, leading to higher levels of teamwork. However, with a small sample size, caution must be applied, as the findings might not be generalizable.

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“…Patient-centered care uses the concept of shared decision-making to ensure the treatment plan accounts for the patient's desired outcomes as well as the physicians, and has been shown across multiple fields of medicine and surgery to improve patient satisfaction. [25][26][27] In order to ensure care is patient centered, caregiver must be readily available. This includes surgeons, nurses and all members of the health-care team.…”

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confidence: 99%

<p>A Qualitative Assessment of Patient Satisfaction with Radical Cystectomy for Bladder Cancer at a Single Institution: How Can We Improve?</p>

Hockman

Bailey

Sanders

et al. 2020

RRU

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Purpose: To evaluate patient satisfaction (with emphasis on preoperative education) with radical cystectomy for bladder cancer at our institution, the University of Missouri Hospital, qualitatively in order to identify specific areas where improvements can be made. Materials and Methods: We developed a patient survey that used open-ended questions to identify positive and negative experiences that contributed to patient satisfaction. We administered the survey to radical cystectomy patients who met inclusion criteria and agreed to participate. We recorded, transcribed and qualitatively coded the responses. We identified four themes under which both positive and negative responses were placed, and constructed two diagrams to better illustrate contributors to patient experience and satisfaction. Results: We identified 25 patients who met inclusion criteria. Of those, 13 participated in the survey. Regarding overall experience, 92.3% of patients rated their care as excellent or good. Regarding preoperative education, 76.9% of patients reported they definitely or somewhat received enough information on what to expect after surgery, and 76.9% definitely received enough guidance on how to care for themselves after surgery. From qualitative coding of patient responses to open-ended questions, we identified preoperative preparation, delivery of care, caregiver availability, and patient-centered care as themes that contributed positively and negatively to patient experience. Conclusion: Although the overall patient satisfaction could be perceived as high (92.3%), qualitative analysis revealed several areas where improvements can be made to improve patient experience with radical cystectomy at our institution. As previously expected, preoperative preparation was a contributor.

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One-day diagnosis for hepatobiliary and pancreatic lesions: An innovative patient-centered care pathway organization

Cited by 8 publications

References 8 publications

Evaluation of an Innovative Care Pathway in the Diagnostic and Therapeutic Management of Hepatobiliary and Pancreatic Pathologies: “One-Day Diagnosis”

Evaluation of an Innovative Care Pathway in the Diagnostic and Therapeutic Management of Hepatobiliary and Pancreatic Pathologies: “One-Day Diagnosis”

The Effect of Care Pathways on Coronary Care Nurses: A Preliminary Study

<p>A Qualitative Assessment of Patient Satisfaction with Radical Cystectomy for Bladder Cancer at a Single Institution: How Can We Improve?</p>

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