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Mapping the Clinical Pathway for Patients Undergoing Vestibular Schwannoma Resection
Siddharth Sinha1, Simon C Williams2, John Gerrard Hanrahan2
1Division of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom; Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom; Francis Crick Institute, London, United Kingdom.
Process mapping identified key data entry points in vestibular schwannoma (VS) care pathways. This enables structured data collection to improve patient care and research, overcoming electronic health record (EHR) limitations.
Area of Science:
- Neurosurgery
- Health Informatics
- Clinical Pathway Analysis
Background:
- Electronic Health Records (EHRs) enhance data collection and research but suffer from data quality issues and manual extraction challenges.
- Vestibular schwannoma (VS) patient data management requires optimization for improved clinical communication and research endeavors.
- Current EHR systems present limitations in efficient and accurate data capture for complex neurosurgical conditions.
Purpose of the Study:
- To utilize process mapping to identify critical data entry points in the clinical pathway for vestibular schwannoma (VS) patients.
- To enhance structured data entry and automated data collection for improved patient care and research outcomes.
- To address limitations in EHR data quality and manual extraction through targeted process improvements.
Main Methods:
- A 2-stage methodology involving process map development and retrospective EHR validation was employed.
- Semi-structured interviews with 20 stakeholders in VS resection management informed process map creation.
- Process maps were validated against EHR data from 36 VS resection patients (August 2019 - December 2021).
Main Results:
- Critical data entry points were identified within operative notes, surgical inpatient reviews, and discharge summaries.
- Significant documentation improvement areas include preoperative clinics (83.3%), skull base multidisciplinary teams (88.9%), and postoperative follow-up clinics (88.9%).
- Validated process maps pinpointed specific stages for enhanced data capture in the VS patient journey.
Conclusions:
- This study pioneers a 2-stage process mapping methodology for the VS resection clinical pathway.
- Identified critical data entry points are suitable for structured data entry and automated collection tools.
- Implementing these improvements is expected to positively impact both patient care and research in VS management.
