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Evidence-based pelvic floor disorder care pathways optimize shared decision making between patients and surgeons
Lauren Caldwell1, Amy E Papermaster2, Gabriela E Halder3
1University of Texas Dell Medical School, 1301 W. 38th Street, Suite 705, Austin, TX, 78705, USA. Lauren.Caldwell@ascension.org.
International Urogynecology Journal
|January 10, 2022
Summary
Care pathways for pelvic organ prolapse (POP) and stress urinary incontinence (SUI) were developed to standardize care. Advanced practice providers use these pathways for shared decision-making, improving patient outcomes and value-based care.
Area of Science:
- Urogynecology
- Pelvic Health
- Evidence-Based Medicine
Background:
- Standardizing care for pelvic organ prolapse (POP) and stress urinary incontinence (SUI) is crucial for improving patient outcomes.
- Multidisciplinary teams require effective decision aids for consistent patient counseling.
Purpose of the Study:
- To develop and implement evidence-based care pathways for POP and SUI.
- To enhance shared decision-making between patients and providers.
- To standardize management across a diverse provider group.
Main Methods:
- A modified Delphi process was used by an expert team to review guidelines and literature.
- Care pathways were created as decision aids for advanced practice providers (APPs).
- Patient evaluation includes symptom and quality-of-life questionnaires, and patient goals.
Main Results:
- Pathways guide initial evaluation and treatment choices (surgical/nonsurgical) presented by APPs.
- Nonsurgical management involves telehealth or in-person follow-up as per pathway.
- Surgical candidates undergo specific bladder testing; postoperative care emphasizes telehealth for uncomplicated cases.
Conclusions:
- Developed POP and SUI care pathways standardize care for patients with prolapse and incontinence.
- APPs utilize these pathways as shared decision-making tools, promoting value-based care.
- Pathways empower team members to function within their full scope of training.
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