International Journal of Care Pathways最新文献

{"title":"Example of data mining use to follow indicators in clinical pathways","authors":"Michelle Le Braz, E. D. Clercq, C. Juillet, N. Garin, A. Perrier","doi":"10.1258/JICP.2012.012M07","DOIUrl":"https://doi.org/10.1258/JICP.2012.012M07","url":null,"abstract":"Objectives: To measure the reliability of data mining for indicators related to patient treatment at hospital discharge. Methods: Design: Retrospective cohort study. Population: Patients discharged alive after an admission for heart failure in a general internal medicine department from 2009 to 2010. Data: Key treatments at patient's discharge extracted from the clinical information system compared with data extracted manually from the medical records. Endpoint: Accuracy of data mining for treatment prescription. Analysis: Sensitivity, specificity, positive and negative predictive values (PPVs and NPVs) of data mining for angiotensin-converting enzyme (ACE) inhibitors and betablockers prescription discharge. The gold standard was manual data extraction. We then investigated causes of discrepancies between the two methods. Results: A total of 724 patients were included. At discharge, 85.2% received an ACE inhibitor and 72.4% a beta-blocker. For ACE inhibitors, data mining yielded a sensitivity of 90%, a specificity of 100%, a PPV of 100% and an NPV of 64%. Corresponding values for beta-blockers were 95%, 100%, 100% and 88%, respectively. Main causes for discrepancy were: omission of some molecules in the electronic query used; non-standard writing of a prescription in the clinical information system; formats incorrectly interpreted by the query. Conclusion: Immediate reliance on data mining for drug prescription is currently unwarranted because this complex process is still prone to errors. Results should be manually checked before they can be used as quality indicators.","PeriodicalId":114083,"journal":{"name":"International Journal of Care Pathways","volume":"37 15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116788216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysphagia screening, evaluation and treatment in stroke: implementation and integration with multiple concurrent clinical pathways","authors":"K. Altman, C. Takizawa, R. Martino, R. Speyer, L. Derex, H. Chevrou-Séverac, R. Altman","doi":"10.1258/JICP.2012.012M01","DOIUrl":"https://doi.org/10.1258/JICP.2012.012M01","url":null,"abstract":"","PeriodicalId":114083,"journal":{"name":"International Journal of Care Pathways","volume":"125 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130259871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State of the art of research in care pathways: do care pathways work?","authors":"M. Panella, K. Vanhaecht","doi":"10.1258/JICP.2012.012M52","DOIUrl":"https://doi.org/10.1258/JICP.2012.012M52","url":null,"abstract":"","PeriodicalId":114083,"journal":{"name":"International Journal of Care Pathways","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132181594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving interprofessional teamwork with care pathways: challenges for pathway researchers and health-care managers","authors":"S. Deneckere, M. Euwema, C. Lodewijckx, M. Panella, W. Sermeus, K. Vanhaecht","doi":"10.1258/JICP.2012.012M05","DOIUrl":"https://doi.org/10.1258/JICP.2012.012M05","url":null,"abstract":"","PeriodicalId":114083,"journal":{"name":"International Journal of Care Pathways","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124920913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a care pathway for exacerbation of chronic obstructive pulmonary disease: a cluster randomized controlled trial","authors":"C. Lodewijckx, W. Sermeus, M. Panella, S. Deneckere, F. Leigheb, M. Decramer, K. Vanhaecht","doi":"10.1258/JICP.2012.012M09","DOIUrl":"https://doi.org/10.1258/JICP.2012.012M09","url":null,"abstract":"","PeriodicalId":114083,"journal":{"name":"International Journal of Care Pathways","volume":"2012 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129853076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Spanish version of the care process self-evaluation tool","authors":"R. Camacho-Bejarano, M. Mariscal-Crespo, W. Sermeus, K. Vanhaecht, Dolores Merino-Navarro","doi":"10.1258/JICP.2012.012M03","DOIUrl":"https://doi.org/10.1258/JICP.2012.012M03","url":null,"abstract":"","PeriodicalId":114083,"journal":{"name":"International Journal of Care Pathways","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134465817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between patient involvement and hospital accreditation standards","authors":"A. M. Murante, S. Nuti","doi":"10.1258/JICP.2012.012M12","DOIUrl":"https://doi.org/10.1258/JICP.2012.012M12","url":null,"abstract":"","PeriodicalId":114083,"journal":{"name":"International Journal of Care Pathways","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116186203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Care pathways within orthopaedics: alike when possible, different when necessary","authors":"F. V. Ewijk, M. A. Hugo","doi":"10.1258/JICP.2012.012M15","DOIUrl":"https://doi.org/10.1258/JICP.2012.012M15","url":null,"abstract":"","PeriodicalId":114083,"journal":{"name":"International Journal of Care Pathways","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125296544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Step by step towards a clinical pathway","authors":"E. Zwaan, V. Umans","doi":"10.1258/jicp.2012.010031","DOIUrl":"https://doi.org/10.1258/jicp.2012.010031","url":null,"abstract":"Clinical pathways attempt to increase efficiency by organizing the care delivery process into individual analysable steps. We evaluate a digital clinical pathway for electrocardioversion in atrial fibrillation with a nurse coordinator in the ongoing consecutive experience in clinical practice. This paper describes the implementation and effects of introducing a clinical pathway. The pathway was launched in January 2008. Up to January 2009, 450 all-comer elective patients have been treated using this integrated digital clinical pathway without exception. Treatment and outpatient check-up appointments are made immediately for all patients. The pathway reduced walk-through times significantly. A clinical pathway for cardioversion patients is safely and efficaciously introduced in a teaching hospital.","PeriodicalId":114083,"journal":{"name":"International Journal of Care Pathways","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115213952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new model of care pathways for reorganization of chronic care","authors":"C. Lodewijckx, K. Vanhaecht, M. Panella","doi":"10.1258/jicp.2011.011m33","DOIUrl":"https://doi.org/10.1258/jicp.2011.011m33","url":null,"abstract":"The rise of chronic diseases represents major challenges for actual health-care systems. Most developed countries are facing growing health-care costs due to an aging population in which 70% of health-care expenses are related to chronic diseases, and the current fragile economic climate may progressively limit resources available to health-care systems. Another challenge lies in the actual organization of health-care delivery systems. Current health-care delivery systems are often unable to meet the complex needs of chronically ill patients for several reasons. Firstly, health care is traditionally focused on acute care management and short-term goals. Secondly, fragmented delivery of health and social services, including disconnection of primary and secondary care, is an acknowledged problem in many health-care systems. Thirdly, too often chronic care approaches feature an uninformed, passive patient interacting with a poorly coordinated team of health professionals, resulting in frustrating and inadequate encounters. Finally, despite the availability of worldwide evidence-based practice guidelines for a wide range of chronic diseases, the use of evidencebased standards remains limited. A well-established model designed to guide the reorganization of health-care delivery systems from acute and reactive care to proactive, planned and community-based care is the Chronic Care Model (CCM) developed by Wagner et al. In this systemic model, improved functional and clinical outcomes of disease management are the results of productive interactions between informed, activated patients and a prepared, proactive practice team of healthcare professionals. These productive interactions are supported by six components: health-care organization, community resources, self-management support delivery system design, decision support, and clinical information systems. To better integrate aspects of prevention and health promotion into the CCM, an enhanced version called the Expanded Chronic Care Model was developed by Barr et al. The CCM has been used widely to guide the reorganization of health-care delivery systems; however, implementation has been shown to be fragmented and limited to one or two components, mostly including self management, multidisciplinary teamwork and information systems. This defragmented and limited implementation may explain today’s poor integration of care across organizations, unbalanced skill mix and lack of patient involvement in the current health-care delivery systems. Furthermore, practices and change strategies used to reorganize health care according to CCM delivery systems vary highly across health-care systems. Several attempts have been made to adequately measure the effectiveness of reorganizing care according to the CCM. However, because of defragmented implementation, different change strategies and different measuring methods and outcome indicators, the effectiveness of reorganizing health-care delivery systems according ","PeriodicalId":114083,"journal":{"name":"International Journal of Care Pathways","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121926316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}