The impact of care pathways for patients with proximal femur fracture: rationale and design of a cluster-randomized controlled trial

Vanhaecht, Kris; Sermeus, Walter; Peers, Jan; Lodewijckx, Cathy; Deneckere, Svin; Leigheb, Fabrizio; Boonen, Steven; Sermon, An; Boto, Paulo; Mendes, Rita; Panella, Massimiliano

doi:10.1186/1472-6963-12-124

Cited by 25 publications

(14 citation statements)

References 40 publications

(79 reference statements)

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“…Italian literature tended to portray HIS as a set of tools and techniques to solve particular problems, rather than as a generalizable theory, discipline, or science. Examples included strategies to improve organization performance and the overall quality of care, in terms of medication or communication with clients/patients [20,21,22,23,24,25,26,27,28,29,30,31,32,33,34].…”

Section: Resultsmentioning

confidence: 99%

Mapping the Status of Healthcare Improvement Science through a Narrative Review in Six European Countries

Crespo

Sierras-Davó

Taylor

et al. 2019

IJERPH

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With the aim to explore how improvement science is understood, taught, practiced, and its impact on quality healthcare across Europe, the Improvement Science Training for European Healthcare Workers (ISTEW) project “Improvement Science Training for European Healthcare Workers” was funded by the European Commission and integrated by 7 teams from different European countries. As part of the project, a narrative literature review was conducted between 2008 and 2019, including documents in all partners’ languages from 26 databases. Data collection and analysis involved a common database. Validation took place through partners’ discussions. Referring to healthcare improvement science (HIS), a variety of terms, tools, and techniques were reported with no baseline definition or specific framework. All partner teams were informed about the non-existence of a specific term equivalent to HIS in their mother languages, except for the English-speaking countries. A lack of consensus, regarding the understanding and implementation of HIS into the healthcare and educational contexts was found. Our findings have brought to light the gap existing in HIS within Europe, far from other nations, such as the US, where there is a clearer HIS picture. As a consequence, the authors suggest further developing the standardization of HIS understanding and education in Europe.

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Section: Resultsmentioning

confidence: 99%

Mapping the Status of Healthcare Improvement Science through a Narrative Review in Six European Countries

Crespo

Sierras-Davó

Taylor

et al. 2019

IJERPH

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“…Defining characteristics of care pathways include “facilitation of communication, coordination of roles, and sequencing the activities of the multidisciplinary care team, patients and their relatives” [8]. In particular, the complexity of the challenges facing patients with cancer necessitates a comprehensive, multidisciplinary, and psychosocial approach to care [9].…”

Section: Introductionmentioning

confidence: 99%

Patient and Health Care Professional Perspectives: A Case Study of the Lung Cancer Integrated Care Pathway

Bravi¹,

Ruscio²,

Frassoldati³

et al. 2018

International Journal of Integrated Care

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Introduction:The purpose of this study was to evaluate the perception of the quality of care, considering both patient experience and health care professionals’ perceptions as well as patient outcome measures of an integrated lung cancer pathway.Methods:A cross-sectional study was conducted in 2016 at Ferrara University Hospital, Italy. OPportunity for Treatment In ONcology (OPTION) questionnaires were administered to 77 patients, and the Care Process Self-Evaluation Tool (CPSET) questionnaires were given to 38 health care professionals. The effectiveness of the pathway was evaluated by analysing the tool’s positive impact on lung cancer surgery volume and 30-day mortality.Results:Seventy-seven patients were enrolled, and 38 health care professionals assessed the CPSET questionnaire. The highest scores were related to “respect” (100%), “satisfaction” (98.7%), and “trust” (97.4%) on the OPTION and to “patient-focused vision” (97.2%) and “patient engagement” (94.4%) on the CPSET. The lowest scores were related to “information” (26%) and “cooperation with general practitioner” (17.6%) on the OPTION and “cooperation between the hospital and primary care” (23.5%) for the CPSET. The outcomes analysis shows an increase in the volume of activity and a decrease in 30-day mortality after pathway implementation.Discussion:The lung cancer pathway is a patient-centred intervention that enables care to be shaped for patient needs in order to improve the quality and efficiency of service and clinical outcome.

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“…In lower extremity fractures, femoral fracture is associated with considerable morbidity [ 7 , 8 ]. Nonetheless, the incidence of femoral fracture is a complex phenomenon.…”

Section: Introductionmentioning

confidence: 99%

Location of Femoral Fractures in Patients with Different Weight Classes in Fall and Motorcycle Accidents: A Retrospective Cross-Sectional Analysis

Chang

Liu

Huang

et al. 2018

IJERPH

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Background: This study aimed to determine the incidence of femoral fracture location in trauma patients with different weight classes in fall and motorcycle accidents. Methods: A total of 2647 hospitalized adult patients with 2760 femoral fractures from 1 January 2009 to 31 December 2014 were included in this study. Femoral fracture sites were categorized based on their location: proximal femur (type A, trochanteric; type B, neck; and type C, head), femoral shaft, and distal femur. The patients were further classified as obese (body mass index [BMI] of ≥30 kg/m2), overweight (BMI of <30 but ≥25 kg/m2), normal weight (BMI of <25 but ≥18.5 kg/m2), and underweight (BMI of <18.5 kg/m2). Odds ratios and 95% confidence intervals of the incidences of femoral fracture location were calculated in patients with different weight classes in fall or motorcycle accidents, and they were then compared with those in patients with normal weight. p values of <0.05 were considered statistically significant. Results: Most of the fractures sustained in fall accidents presented in the proximal type A (41.8%) and type B (45.3%) femur, whereas those sustained in motorcycle accidents involved the femoral shaft (37.1%), followed by the distal femur (22.4%) and proximal type A femur (21.2%). In fall accidents, compared with normal-weight patients, obese and overweight patients sustained lower odds of risk for proximal type B fractures but higher odds of risk for femoral shaft and distal femoral fractures. In motorcycle accidents, compared with normal-weight patients, obese patients sustained lower odds of risk for proximal type B fractures but no difference in odds of risk for femoral shaft and distal femoral fractures. Overweight and underweight patients who sustained fractures in a motorcycle accident did not have different fracture location patterns compared with normal-weight patients. Conclusions: This study revealed that femoral fracture locations differ between fall and motorcycle accidents. Moreover, greater soft tissue padding may reduce impact forces to the greater trochanteric region in obese patients during fall accidents, and during motorcycle accidents, the energy transmitted and the point of impact may dominantly determine the location of femoral fractures.

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The impact of care pathways for patients with proximal femur fracture: rationale and design of a cluster-randomized controlled trial

Cited by 25 publications

References 40 publications

Mapping the Status of Healthcare Improvement Science through a Narrative Review in Six European Countries

Mapping the Status of Healthcare Improvement Science through a Narrative Review in Six European Countries

Patient and Health Care Professional Perspectives: A Case Study of the Lung Cancer Integrated Care Pathway

Location of Femoral Fractures in Patients with Different Weight Classes in Fall and Motorcycle Accidents: A Retrospective Cross-Sectional Analysis

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