This document provides an outline and overview of clinical pathways. It begins with the history and origins of clinical pathways in the 1980s. It then defines clinical pathways as multidisciplinary tools to standardize and optimize care for specific patients based on evidence. The document discusses why pathways are used, including to improve quality of care, maximize efficiency, reduce variability, and support clinical effectiveness. It also covers potential issues, benefits, components of pathways, and how pathways are developed through a multidisciplinary process.
Clinical practice guidelines are “systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.”They are intended to offer concise instructions on how to provide healthcare services.The most important benefit of clinical practice guidelines is their potential to improve both the quality or process of care and patient outcomes. Increasingly, clinicians and clinical managers must choose from numerous, sometimes differing, and occasionally contradictory, guidelines.
Clinical practice guidelines are “systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.”They are intended to offer concise instructions on how to provide healthcare services.The most important benefit of clinical practice guidelines is their potential to improve both the quality or process of care and patient outcomes. Increasingly, clinicians and clinical managers must choose from numerous, sometimes differing, and occasionally contradictory, guidelines.
patient safety and staff Management system ppt.pptxanjalatchi
Patient Safety is a health care discipline that emerged with the evolving complexity in health care systems and the resulting rise of patient harm in health care facilities. It aims to prevent and reduce risks, errors and harm that occur to patients during provision of health care.
Patient safety is the absence of preventable harm to a patient during the process of health care and reduction of risk of unnecessary harm associated with health.
patient safety and staff Management system ppt.pptxanjalatchi
Patient Safety is a health care discipline that emerged with the evolving complexity in health care systems and the resulting rise of patient harm in health care facilities. It aims to prevent and reduce risks, errors and harm that occur to patients during provision of health care.
Patient safety is the absence of preventable harm to a patient during the process of health care and reduction of risk of unnecessary harm associated with health.
A review of the total knee replacement pathway: Integrated care is quality careApollo Hospitals
A Total Knee Replacement (TKR) Pathway (adapted from the Credit Valley Hospital, Canada) is in place at the Apollo Health city facility since 2011. We re-visited the pathway design and the priority grid that led to its adaptation. We analyzed the data with the aim to analyze repetitive and unique trends and evaluate the performance of the pathway. Even with the increased volume the patient satisfaction rose from 56% at the time of pathway implementation to 77% at the end of the evaluation period of 45 months. The Average Length of Stay reduced by 27% from 7.94 to 5.78 days (the difference between the initial and final recorded values), in the same evaluation time period. The methodology of evaluation of the pathway was adapted from the Leuven Clinical Pathway Compass 5 way approach.
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Patient blood management (PBM) has been proven to improve patient outcomes and save hospitals millions of dollars. Ensuring the quality of your data is central to decision making and critical to having a strong PBM program.
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ITS IMPORTANT TO MEET THE COMPETENCES (Thats how they evaluate the mariuse18nolet
ITS IMPORTANT TO MEET THE COMPETENCES (That's how they evaluate the work).
Nursing within an organization is a critical component of health care delivery and is an essential ingredient in patient outcomes (Kelly & Tazbir, 2014). The concern for quality care that flows from evidence-based practice generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 2: Explain the accountability of the nurse leader for decisions that affect health care delivery and patient outcomes.
(IMPORTANT) -Describe accountability tools and procedures used to measure effectiveness.
Competency 3: Apply management strategies and best practices for health care finance, human resources, and materials allocation decisions to improve health care delivery and patient outcomes.
(IMPORTANT) -Develop an evidence-based plan for health care delivery.
Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.
(IMPORTANT) -Apply professional and legal standards in support of a care plan.
Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.
(IMPORTANT) -Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.
Preparation
Refer to the Capella library and the Internet for supplemental resources to help you complete this assessment.
Instructions
Deliverable:
Develop an evidence-based plan for health care delivery.
Scenario:
The hospital where you work has an issue with increased readmissions within 30 days of discharge. After examining the core measures, it was found that heart failure was the most common core measure disease process experiencing the highest rate of readmissions. The leadership team has given your team the charge of developing a nurse-run outpatient heart failure clinic. The purpose of this clinic is to ensure that discharge education is presented to the patient in an orderly, consistent manner and complies with evidence-based practice protocols. Since these patients may be discharged from a variety of areas in the facility, having the heart failure clinic staff take ownership of the process will improve both consistency and compliance. There are cardiologists that interact with the staff and patients, but the day-to-day operations of the clinic are designed and supported by the nurses as they interact with appropriate members of the other health care team disciplines promoting the best care for the heart failure patients.
As a member of the nurse team, you have been asked to develop
one
component
of the clinic.
The hospital leadership established these objectives ...
Clinical Audit is a method of confirming the quality of clinical services and identify the need for improvement. A skill hospital administrator should learn and practice.
Write a 3 page evidence-based health care delivery plan for one .docxowenhall46084
Write a 3 page evidence-based health care delivery plan for one component of a heart failure clinic.
Nursing within an organization is a critical component of health care delivery and is an essential ingredient in patient outcomes (Kelly & Tazbir, 2014). The concern for quality care that flows from evidence-based practice generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 2: Explain the accountability of the nurse leader for decisions that affect health care delivery and patient outcomes.
Describe accountability tools and procedures used to measure effectiveness.
Competency 3: Apply management strategies and best practices for health care finance, human resources, and materials allocation decisions to improve health care delivery and patient outcomes.
Develop an evidence-based plan for health care delivery.
Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.
Apply professional and legal standards in support of a care plan.
Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.
Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.
In an effort to improve the patients' health literacy concerning heart failure, it is important that the clinic staff and the hospital staff present a consistent, evidence-based message on self-care to these patients and their families in order to decrease acute exacerbation and re-admissions. Review current evidence for clinical practice guides or protocols when developing your patient teaching plans and materials. Consider the following:
What does the patient know about the disease process as a baseline?
What does the patient need to do understand as far as the best self-care processes?
Can the patient identify proper medication compliance?
Is there a financial issue that affects compliance?
Who buys and prepares the food in the home?
Can the patient verbalize when to seek medical assistance?
Instructions
Deliverable:
Develop an evidence-based plan for health care delivery.
Scenario:
The hospital where you work has an issue with increased readmissions within 30 days of discharge. After examining the core measures, it was found that heart failure was the most common core measure disease process experiencing the highest rate of readmissions. The leadership team has given your team the charge of developing a nurse-run outpatient heart failure clinic. The purpose of this clinic is to ensure that discharge education is presented to the patient in an orderly, consistent manner and complies with evidence-based practice protocol.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
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Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
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Stay informed, stay safe, and get your flu shot today!
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1. Clinical pathway
Outline
1- History
2- Introduction
3- Definition of Clinical Pathway
4- Why Clinical Pathways
5- Parts of a Clinical Pathway
6- Selection Criteria
7- Variation
8- Benefits
9- Issues - potential problems and barriers to the introduction of ICPs
10- As active management tools
11- Are Clinical Pathways and Protocols the same thing?
12- Some of the other names used to describe clinical pathways
13- Characterized of clinical pathway
14- Clinical Pathway Development
15- Key indicators for stroke care
16- References
2. History
1-The clinical pathway conceptappeared for the first time at the New England Medical
Center( Boston,USA )in 1985 inspired by Karen Zander and Kathleen Bower. Clinical
pathways appeared as a result of the adaptation of the documents used in industrial
quality management ,the Standard Operating Procedures(SOPs), whose goals are:
Improve efficiency in the use of resources and Finish work in a set time.
2- In April, 1991 in consultation with the Center for Case Management, South Natick,
developed the Home Health Care Map Tools (now called VNA FIRST Home Care
Steps Protocols.
3- In 2005, the telehealth clinical pathway was introduced to standardize telehealth
visits and telephone calls in homecare.
Introduction
Clinical pathways, also known as care pathways, critical pathways, integrated care
pathways, or care maps ,are one of the main tools used to manage the quality in
healthcare concerning the standardization of care processes.It has been proven that their
implementation reduces the variability in clinical practice and improves outcomes.
Clinical pathways promote organized and efficient patient care based on the evidence
based practice. Clinical pathways optimize outcomes in the acute care and homecare
settings.
Definitions of Clinical Pathway
1- Multidisciplinary management toolbased on evidence-based practice for a specific
group of patients with a predictable clinical course, in which the different tasks
(interventions) by the professionals involved in the patient care are defined, optimized
and sequenced either by hour (ED), day (acute care) or visit (homecare). Outcomes are
tied to specific interventions.
2- A clinical pathway is a tool used in achieving coordinated care and desired outcomes
within an anticipated time frame by utilizing the appropriate resources
3. available. A clinical pathway is a blueprint that guides the clinician in the provision of
care.
3- Clinical pathways are pre-conceived patient care algorithms, or paths, that are
intended to reduce variability and cost, increase efficiency, and ultimately improve
patient care.
4- Pathways provide patient focused care with benefits to the patient, family and
members of the multi-disciplinary team. They allow for the continuous evaluation and
improvement of clinical practice and help to stimulate research. Their use represents a
new approachto patient care, fulfilling many of the demands of clinical practice”.
Why Clinical Pathways
Due to the ongoing changes in medical technology it has become necessary that
hospitals begun introducing clinical pathways to cut costs and reduce the variation in
care. There are four major reasons for developing clinical pathways):-
1- To improve patient care by improving the quality of patient care through consistent
management by encouraging patient involvement and by identifying and measuring
improvements in patient care and outcomes.
2-To maximize the efficient use of resources by reducing unnecessary documentation
and overlap and reduced length of hospital stay for particular conditions. Patients who
do not make expected progress can be easily identified and the appropriate interventions
made.
3- To help identify and clarify the clinical processes byensuring continuity of patient
care by reducing unnecessary variations. The development and implementation of
clinical pathways increases collaboration between the disciplines, professionals and
agencies. This ensures continuity of patient care by reducing unnecessary variations in
the management of the patient.
4- To supportclinical effectiveness, clinical audit and risk management. Clinical
pathways also provide an appropriate framework to promote and measure the
4. success ofthe clinical effectiveness cycle, which encompasses:Evidence based practice,
clinical audit, patient involvement, multi-disciplinary, multi-professional working,
outcome measures and Clinical benchmarking.
Parts of a Clinical Pathway
1- Pathway title
2- Inclusion and exclusion criteria
3- Patient’s information
4- Physician’s Notes
S: subjective complaints/symptoms
O: objective physical and laboratory findings
A: assessment/ working diagnosis/ clinical Impression
P: plan of care (diagnostic, therapeutic, rehabilitative, others)
5. Orders
ges)
feedings)
consult/orders)
-limiting, assuring a mother that she can
breastfeed, assuring family that patient’s usual activity may be resumed in 3-7 days)
infection)
5. -
operative care)
Orders or interventions may be mandatory or optional
atory interventions – marked by bullets (•) and applicable to 100% of the
population
by AP
– marked by tick boxes () and may not apply to 100% of the
population
the patient
ne
6. Pathway activation: by the attending physician or resident-in-charge
7. Pathway acknowledgement: by the nurse-in-charge
8. Variance column
9. Signature column
SelectionCriteria
it resources to
establish and implement a clinical pathway for a particular condition
urse
6. ion
Variation
A variation is described as being a detour from the patient care activities outlined in the
clinical pathway. In general practice there are three distinct types of variation:-
Three variation
1- Systems variations - these include organizational failures such as the unavailability of
staff or transport.
2- Health and social care professional variations - these include clinical judgments
Regarding the addition or deletion of specified interventions.
3- Patient variations - these include unexpected illness or complications and patient
care.
Benefits
-based medicine and use of clinical guidelines
ement and clinical audit
-ordination of care across different clinical disciplines
and sectors;
t in clinical practice
7. eline for future initiatives
-defined standards for care.
ations in patient care (by promoting standardization).
documentation.
help ensure quality of care and provide a means of continuous quality
improvement.
Issues - potential problems and barriers to the introduction of ICPs
nexpected changes in a patient's condition
standard conditions better than unusual or unpredictable ones
structure
take time to be accepted in the workplace
8. As active managementtools them:
- Eliminate prolonged lengths of stay arising from inefficiencies, allowing better use of
- Reduce mistakes, duplication of effort and omissions
- Improve communication with patients as to their expected courseof treatment
- Identify problems at the earliest opportunity and correctthese promptly
- Facilitate quality management and an outcomes focus.
Are Clinical Pathways and Protocols the same thing?
-way to be sure that a
document is a true clinical pathway - it will contain structured variance tracking. It is
not:
Some of the other names used to describe clinical pathways include:
1- Anticipated Recovery Pathways (ARPs)
2- Multidisciplinary Pathways of Care (MPCs)
3- Care Protocols
4- Integrated Care Pathways
5- Pathways of Care
9. 6- Care Packages
7- Collaborative Care Pathways
8- Care Maps
9- Care Profiles
Characterizedof clinical pathway
1- Patient centered - built into packages of care for identified groupings
2- Systematic action for consistent best practice, continuous improvements in patient
care, all with attention to the patient experience
3- Continuous feedback via variance tracking and analysis
4- Multidisciplinary - based on roles competence & responsibility rather than discipline
alone
5- Maps and models clinical and non-clinical care processes
6- Incorporates order and priorities including guidelines and protocols
7- Includes standards and outcomes
The Nurse’s role in using pathways:
-in-charge assists the AP in selecting the appropriate pathway.
rvention that are not cancelled and optional
interventions that are checked
Clinical PathwayDevelopment
The implementation of a clinical pathway is most likely to succeed when the decision to
develop is taken on an organizational basis. Senior management commitment and a
strong medical and nursing lead are essential. Pathway documentation is more likely to
be used if it is simple, clear and user friendly. The process ofpathway development
considers why tasks and interventions are performed, and by whom; since it promotes
greater awareness of the role of each
10. professional involved in the care cycle.
The development of a clinical pathway to manage patients presenting with chest
pain includes:
1- Patients, or their representatives.
2- General Practitioners.
3- Paramedics.
4- Accident and Emergency staff.
5- ECG Technicians.
6- Pharmacists.
7- Pathologists.
8- Coronary Care staff.
9- Cardiac Rehabilitation nurses.
10- Social Services and Community Staff and members of Primary Health Care Teams.
11- Cardiac Rehabilitation nurses.
12-Social Services and Community Staff and members of Primary Health Care Teams.
Guidelines for the Developmentand Implementation of ClinicalPathways:
The essential steps in the development and implementation of a clinical pathway are
summarized as follows:
1- Educate and obtain supportfrom physicians and nurse, and establish a
multidisciplinary team.
2- Identify potential obstacles to implementation.
3- Use Quality improvement methods and tools.
4- Determine staff interest and select Clinical Pathways to develop.
5- Collect Clinical Pathway data and medical record reviews of practice patterns.
6- Conductliterature review of clinical practice guidelines.
7- Develop variance analysis system and monitor the compliance with documentation
on Clinical Pathways.
9- Use a pilot Clinical Pathway for 3 to 6 months revise as needed.