what is a care pathway? ali el-ghorr implementation advisor
TRANSCRIPT
What is a Care Pathway?
Ali El-GhorrImplementation Advisor
Overview of presentation Overview of presentation
Different types of care pathways
How to develop an ICP for BPD
Example mental health ICP
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PathwayAlgorithmReferral PathwayProtocolCare PathwayPatient PathwayTriage PathwayService PathwayGuidelineCritical PathwayIntegrated Care Pathway
What’s in a name?What’s in a name?
Algorithm
Care Pathway
Integrated Care Pathway
Algorithm Algorithm
Decision aid
One page summary
Based on evidence
Layed out as a decision tree
Usually used by 1 professional in the care of 1 individual
Clinical judgement still important
Example:
Alcohol Screening and Brief Interventions Algorithm
Care Pathway
Care Pathway Care Pathway
Diagrammatic representation of a journey of care
Multidisciplinary
High level map of care
Based on evidence and good practice
Includes all main referral routes & referral criteria
Describes who is responsible for what
Includes main comorbidities and complications
Applies to ~80% cases
What is an Integrated Care Pathway (ICP)?
Integrated Care Pathway Integrated Care Pathway
A system of care that allows the A system of care that allows the
comparison of planned care comparison of planned care
with care actually givenwith care actually given
Integrated Care PathwaysIntegrated Care Pathways
Focus on the service user
Part of the care record
Map out the expected care (multidisciplinary/multi-agency)
Describe how care should be structured and co-ordinated
Set standards along the care journey based on the evidence &
best practice
Facilitate the monitoring of these standards through VARIANCE
tracking
Mental HealthMental Health
ICPs ICPs
Policy Context Policy Context
Delivering for Mental Health (Dec 2006):
National policy to improve
mental health services
through development and
implementation of
Integrated Care Pathways
Person-centred
Safe
Effective
The Healthcare Quality The Healthcare Quality Strategy for NHSScotlandStrategy for NHSScotland
QIS standards
ICP StandardsICP Standards
How do you develop an ICP for BPD?
Process StandardsProcess Standards
Stakeholder involvement
Process mapping
Delivering togetherDelivering together
Psychologists
Consultants
Nurses
AHPsSocial Work
Improvement Support Staff Service users and carers
Local Teams
Voluntary sector Managers
GPs
Involving Primary Care
Possible incentivesPossible incentives
- ICP links to Quality Outcomes Framework: Mental health register
Physical health checksDementia reviewDepression screeningDepression assessment using validated tool
- ICPs linked to psychological therapies HEAT target
High level
Increasing level of detail
Process Mapping
Opportunity for Redesign
Content
Service user at the centre of care planning
Comprehensive assessment
Risk management
A service user rated measure of needs (eg Avon)
Targeted inpatient admission
Measure outcome
There is a record of medication for BPD
Example:
NHS Tayside mental health admission and discharge ICP
Admission & Discharge ICPAdmission & Discharge ICP
Implementation
Local implementation
Part of local strategy
Identify local champions / leads
Embed ICP work within Care Governance
Conduct awareness raising & education
Repeat education programme
Audit, review & provide feedback
Support availableSupport available
National ICP toolkit (www.icptoolkit.org)
Network of National ICP Co-ordinators & ICP Team
BPD Network
Co-ordinated approach (Health Directorates, NHS
Education Scotland, Social Work, Care
Commission and others)
IncentivesIncentives
Quality strategy (person centred, safe, effective)
Patient safety in mental health
HEAT targets in mental health
Quality Outcomes Framework
Partnership working (Social Work & Voluntary Sector
ICP accreditation
ConclusionsConclusions
Different types of care pathways
ICPs are a system of care
ICPs are a tool for service redesign and continuous quality improvement
Focus on service user and meeting their needs
Support and help is available
www.icptoolkit.org
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