Related Experiment Videos
Does an integrated care pathway improve processes of care in stroke rehabilitation? A randomized controlled trial
David Sulch1, Andrew Evans, Anne Melbourn
1Department of Adult Medicine, Queen Elizabeth Hospital, Stadium Road, Woolwich, London SE18 4QH, UK. dsulch@doctors.org.uk
Objective:
to evaluate whether integrated care pathways improve the processes of care in stroke rehabilitation.
Design:
comparison of processes of care data collected in a randomized controlled trial.
Participants:
acute stroke patients undergoing rehabilitation randomized to receive integrated care pathways management (n=76) or conventional multidisciplinary care (n=76).
Measurements:
proportion of patients meeting recommended standards for processes of care using a validated stroke audit tool.
Results:
integrated care pathways methodology was associated with higher frequency of stroke specific assessments, notably testing for inattention (84% versus 60%; P=0.015) and nutritional assessment (74% versus 22%, P<0.001). Documentation of provision of certain information to patients/carers (89% versus 70%; P=0.024) and early discharge notification to general practitioners (80% versus 45%; P<0.001) were also more common in this group. There were no significant differences in the processes of interdisciplinary co-ordination and patient management between the integrated care pathways group and the control group.
Conclusion:
integrated care pathways may improve assessment and communication, even in specialist stroke settings.