NKP. Netwerk Klinische Paden

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1 NKP Netwerk Klinische Paden CZV-KULeuven, 2000 Clinical Pathways in Belgium & The Netherlands Kris Vanhaecht (RN, MSc, PhD Cand) & BDCPW Team Belgian Dutch Clinical Pathway Network Center for Health Services and Nursing Research Catholic University Leuven, Belgium Netwerk Klinische Paden, CZV-KULeuven, 2004

Dutch Clinical Pathway Network Center for Health Services and Nursing

2 Content Who are we? Definition Clinical Pathway History Partners Team Strategy Research Education TaskForces

3 Catholic University Leuven Brussels Leuven Catholic University Leuven Faculty of Medicine School of Public Health Center for Health Services and Nursing Research Netwerk Klinische Paden, CZV-KULeuven, 2004

Public Health Center for Health Services and

5 CPW Definition It is a collection of methods and tools to guide the members of a multidisciplinary and interdisciplinary team towards patient focussed collaboration for a specific patient population. It is a way of identifying and defining the different tasks of the different teammembers. The goal is to assure qualitative and efficient care. It is a tool to systematically plan and follow-up a patient focussed care programme.

It is a way of identifying and defining the different tasks of the different teammembers.

6 History of CPW (1) 1997: First Publication (Sermeus, 1997) Literature review on concept 1998: 6 pilot studies 1999: Workshop 2000: Start Belgian Dutch Clinical Pathway Network 2003: Strategic Partnership with Dutch Institute for Healthcare Improvement (CBO)

Workshop 2000: Start Belgian Dutch Clinical Pathway Network

7 History (2) BDCPW Network Partners Belgium Netherlands (KUL) Netherlands (CBO) Total Number

8 Members Belgian Dutch Clinical Pathway Network - Sept. 04 Delft Reinier de Graaf Spijkenisse Ruwaard van Putten Sint Niklaas Maria Middelares Dendermonde St Blasius Gent St. Lucas Maria Middelares Oostende Damiaan H. Serruys Zee Inst. Orth. Den Haag Leyenburg Rotterdam Oogziekenhuis Roeselare H.Hart Kortrijk Groeninge Zottegem Sint Elisabeth Ronse Zusters van Barmhartigheid Brugge St. Jan Sint Lucas Wit gele Kruis W-VL Aalst Stedelijk Ziekenhuis OLV Ziekenhuis Leiden Hoorn Diaconessenhuis Westfries Gasthuis Amsterdam OLV Gasthuis Antoni Van Leeuwenhoek VUMC Dordrecht A. Schweitzer Turnhout St. Elisabeth Sint Jozef Brasschaat Klina Deinze St.Vincentiusziekenhuis Mechelen- Duffel Sint Maarten Bonheiden Imelda Brussel WG Kruis Melsbroek MS Centrum Almelo Twenteborg Antwerpen Sint Augustinus Middelheim Sint Vincentius Geel St Dimpna Heusden St Fransiscus Eupen St Nikolaus Leeuwarden Medisch Centrum Heerenveen Tjongerschans Nieuwegein St. Antonius Malle Sint Jozef Sint Truiden Sint Trudo Tongeren Leuven Vesalius Universitaire Ziekenhuizen Wit Gele Kruis VL- Brabant UZ Antwerpen Hof Ter Schelde Vzw Monica Genk Overpelt MS Centrum ZOL WG Kruis Limburg Hasselt Virga Jesse Salvator/ Sint Ursula Sittard Orbis Heerlen Atrium Amersfoort Meander MC Enschede Medisch Spectrum Winterswijk Koningin Beatrix Deurne Maastricht Acad. Ziekenhuis

Hart Kortrijk Groeninge Zottegem Sint Elisabeth Ronse Zusters van Barmhartigheid Brugge St.

9 Database on CPW projects

10 CPW Team A.Vleugels MD, PhD Director W. Sermeus RN, PhD Co-ordinator R. Depreitere MSc Deputy Co-ordinator K. Vanhaecht K. De Witte RN, MSc, PhD PhD Cand Research Research Fellow Fellow R. Van Zelm MSc Deputy Co-ordinator E. Klokman MSc Research Fellow L. Debleser RN, MSc Research Fellow J.Vlayen MD Research Fellow

De Witte RN, MSc, PhD PhD Cand Research Research Fellow Fellow R.

11 CPW Team (2) Extended team: Center for Evidence Based Medicine Belgian branch of Cochrane Faculty of Applied Economics Cost Accounting Team Operations Management Team Computer Sciences

12 Strategy Strategic Level of BDCPW Network Contract Healthcare Organisation University Signed by CEO of organisation Signed by Director of Center for HSNR (Prof. Vleugels) 3 year contract Annual fee of 5000 Win Win relation University has methodological know-how Organisations have know-how in clinical field Clinical Pathway Level Own definition (Sermeus & Vanhaecht, 2002) Organisations choose projects CPW focus on change projects within multidisciplinary teams 30 step methodology to develop, implement and evaluate CPW based on PDCA cycle (Vanhaecht & Sermeus, 2002) Clinical Pathway Compass (Vanhaecht & Sermeus, 2003)

Vleugels) 3 year contract Annual fee of 5000 Win Win relation University has methodological know-how Organisations have know-how in clinical field Clinical

13 Belgian Dutch Clinical Pathway Network Education Task Forces Research Publications

14 The BDCPW Network: Education Courses: ½ day course (every 3 months / open to all healthcare workers from Network Organisations) 2 day course (every 10 months) 3 day course (every 10 months) Evening course for MD s (every 6 months) 10 day Expert Course for CPW Facilitators (yearly) 7 day Intensive Course for CPW Facilitators (New) In House Training (½ day 2 days) Peer Review Co-ordinators meetings in Leuven or Utrecht (every 8 weeks) CPW Facilitator meetings in Leuven (every 3 months)

day Expert Course for CPW Facilitators (yearly) 7 day Intensive Course for CPW Facilitators (New) In House Training (½

15 The BDCPW Network: Task Forces (1) Strategic Management CEO s of organisations ICT Cost Accounting Surveys & Measurement Instruments Clinical Peer Review Meetings Clinical Pathways in Palliative Care Clinical Pathways in Rehabilitation Clinical Pathways from hospital to homecare Clinical Task Forces Total Hip Arthroplasty Total Knee Arthroplasty Stroke Normal Delivery

in Palliative Care Clinical Pathways in Rehabilitation Clinical Pathways from hospital to

16 The BDCPW Network: Task Forces (2) Benchmarking on Pain after Normal Delivery Benchmark 23 hospitals Hospital 15 Boxplot VAS pain scores (n=562) Boxplot VAS pain scores (n=25) DAY 0 DAY 0 DAY 1 DAY 1 DAY 2 DAY 2 DAY 3 DAY 3 DAY 4 DAY 5 DAY 4 DAY 5 Belgian Dutch Clinical Pathway Network, CZV-KULeuven / CBO, 2003

VAS pain scores (n=25) DAY 0 DAY 0 DAY 1 DAY 1 DAY 2 DAY 2 DAY 3 DAY 3 DAY 4

17 The BDCPW Network: Task Forces (3) Total Knee Arthroplasty Length of Stay Hosp 6 8,96 (7,81, 10,11) Hosp 13 10,05 (9,32, 10,78) Hosp 2 11,63 (10,49, 12,76) Hosp 7 12,33 (10,85, 13,82) Hosp 1 12,44 (10,89, 13,99) Hosp 20 13,00 (10,93, 15,05) Hosp 21 13,00 (10,93, 15,08) Hosp 16 13,20 (11,72, 14,68) Benchmark 13,37 (12,85, 13,88) Hosp 3 13,52 (11,57, 15,47) Hosp 22 14,04 (12,23, 15,85) Hosp 4 14,65 (12,75, 16,55) Hosp 5 15,13 (14,19, 16,07) Hosp 17 15,80 (14,01, 17,59) Hosp 9 16,84 (14,82, 18,86)

(10,93, 15,08) Hosp 16 13,20 (11,72, 14,68) Benchmark 13,37 (12,85, 13,88) Hosp 3 13,52 (11,57, 15,47) Hosp 22 14,04 (12,23,

18 The BDCPW Network: Research PhD s: Clinical Pathway Audit Tool (Vanhaecht, Sermeus, De Witte) Cost Accounting (Van Herck & Roodhooft) Operations Management (Lambrecht & Demeulemeester) ICT (Verbaeten et al.) Research Projects (Masters) Clinical Pathways & Business Proces Orientation (Sermeus et al) Clinical Pathways & Patient Satisfaction (Sermeus et al) Literature Reviews on Clinical Pathways (Sermeus et al) Clinical Pathways & Team Effectivity (De Witte et al) Clinical Pathways & Relational Co-ordination (De Witte et al) Research Projects for Belgian Governement (Sermeus et al) Clinical Pathways & DRG s Clinical Pathways & Evidence Based Medicine Clinical Pathways & Capacity Planning

) Research Projects (Masters) Clinical Pathways & Business Proces Orientation (Sermeus et al) Clinical Pathways & Patient Satisfaction (Sermeus et al) Literature Reviews on

19 Publications Sermeus, Vanhaecht K, Vleugels A. The Belgian - Dutch Clinical Pathway Network. Journal of Integrated Care Pathways 2001; 5:10-14 Vanhaecht, Sermeus W. The Leuven Clinical Pathway Compass. Journal of Integrated Care Pathways 2003; 7:2-7 Van Herck P, Vanhaecht K, Sermeus W. Effects of clinical pathways: A search for Indicators. Journal of Integrated Care Pathways 2004; Accepted for publication Vanhaecht, Sermeus W, Vleugels A, Peeters G. Ontwikkeling en gebruik van klinische paden (clinical pathways) in de gezondheidszorg. Tijdschrift voor Geneeskunde 2002; 58: (Dutch) Sermeus, Vanhaecht K. Wat zijn klinische paden? Acta Hospitalia 2002; 3:5-11 (Dutch) Vanhaecht, Sermeus W. Draaiboek voor de ontwikkeling, implementatie en evaluatie van een klinisch pad. 30 stappenplan van het Netwerk Klinische Paden. Acta Hospitalia 2002; 2:13-27 (Dutch) Sermeus, Giebens Y, Vanhaecht K, De Witte K, Haspeslagh M, Vleugels A. Het Vlaams-Nederlands Netwerk Klinische Paden. Acta Hospitalia 2002; 2:29-39 (Dutch) Acta Hospitalia, special edition: 13 case studies from BDCPW Network (Dutch)

Journal of Integrated Care Pathways 2004; Accepted for publication Vanhaecht, Sermeus W, Vleugels A, Peeters G. Ontwikkeling en gebruik van klinische paden (clinical pathways) in de gezondheidszorg.

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