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Care pathways across the primary-hospital care continuum: using the multi-level framework in explaining care coordination.

Van Houdt S, Heyrman J, Vanhaecht K, Sermeus W, De Lepeleire J - BMC Health Serv Res (2013)

Bottom Line: Evidence is sparse about the relationship between care pathways and care coordination.The multi-level framework explores care coordination across organizations and states that (inter)organizational mechanisms have an effect on the relationships between healthcare professionals, resulting in quality and efficiency of care.The aim of this study was to assess the extent to which care pathways support or create elements of the multi-level framework necessary to improve care coordination across the primary-hospital care continuum.The construction and use of these inter-organizational mechanisms had a positive effect on exchanging information, formulating and sharing goals, defining and knowing each other's roles, expectations and competences and building qualitative relationships.Care pathways across the primary-hospital care continuum enhance the components of care coordination.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General Practice, Katholieke Universiteit Leuven, Kapucijnenvoer 33 blok J, box 7001, 3000 Leuven, Belgium. sabine.vanhoudt@med.kuleuven.be

ABSTRACT

Background: Care pathways are widely used in hospitals for a structured and detailed planning of the care process. There is a growing interest in extending care pathways into primary care to improve quality of care by increasing care coordination. Evidence is sparse about the relationship between care pathways and care coordination.The multi-level framework explores care coordination across organizations and states that (inter)organizational mechanisms have an effect on the relationships between healthcare professionals, resulting in quality and efficiency of care.The aim of this study was to assess the extent to which care pathways support or create elements of the multi-level framework necessary to improve care coordination across the primary-hospital care continuum.

Methods: This study is an in-depth analysis of five existing local community projects located in four different regions in Flanders (Belgium) to determine whether the available empirical evidence supported or refuted the theoretical expectations from the multi-level framework. Data were gathered using mixed methods, including structured face-to-face interviews, participant observations, documentation and a focus group. Multiple cases were analyzed performing a cross case synthesis to strengthen the results.

Results: The development of a care pathway across the primary-hospital care continuum, supported by a step-by-step scenario, led to the use of existing and newly constructed structures, data monitoring and the development of information tools. The construction and use of these inter-organizational mechanisms had a positive effect on exchanging information, formulating and sharing goals, defining and knowing each other's roles, expectations and competences and building qualitative relationships.

Conclusion: Care pathways across the primary-hospital care continuum enhance the components of care coordination.

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Related in: MedlinePlus

The multi-level framework.
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Figure 1: The multi-level framework.

Mentions: By using the same organizational mechanisms both within and between organizations, networks are even more strengthened, resulting in more quality and efficiency of care [19]. Quality and efficiency are considered as important “patient outcomes” and “inter-organizational outcomes”. The multi-level framework is illustrated in Figure 1.


Care pathways across the primary-hospital care continuum: using the multi-level framework in explaining care coordination.

Van Houdt S, Heyrman J, Vanhaecht K, Sermeus W, De Lepeleire J - BMC Health Serv Res (2013)

The multi-level framework.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750930&req=5

Figure 1: The multi-level framework.
Mentions: By using the same organizational mechanisms both within and between organizations, networks are even more strengthened, resulting in more quality and efficiency of care [19]. Quality and efficiency are considered as important “patient outcomes” and “inter-organizational outcomes”. The multi-level framework is illustrated in Figure 1.

Bottom Line: Evidence is sparse about the relationship between care pathways and care coordination.The multi-level framework explores care coordination across organizations and states that (inter)organizational mechanisms have an effect on the relationships between healthcare professionals, resulting in quality and efficiency of care.The aim of this study was to assess the extent to which care pathways support or create elements of the multi-level framework necessary to improve care coordination across the primary-hospital care continuum.The construction and use of these inter-organizational mechanisms had a positive effect on exchanging information, formulating and sharing goals, defining and knowing each other's roles, expectations and competences and building qualitative relationships.Care pathways across the primary-hospital care continuum enhance the components of care coordination.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General Practice, Katholieke Universiteit Leuven, Kapucijnenvoer 33 blok J, box 7001, 3000 Leuven, Belgium. sabine.vanhoudt@med.kuleuven.be

ABSTRACT

Background: Care pathways are widely used in hospitals for a structured and detailed planning of the care process. There is a growing interest in extending care pathways into primary care to improve quality of care by increasing care coordination. Evidence is sparse about the relationship between care pathways and care coordination.The multi-level framework explores care coordination across organizations and states that (inter)organizational mechanisms have an effect on the relationships between healthcare professionals, resulting in quality and efficiency of care.The aim of this study was to assess the extent to which care pathways support or create elements of the multi-level framework necessary to improve care coordination across the primary-hospital care continuum.

Methods: This study is an in-depth analysis of five existing local community projects located in four different regions in Flanders (Belgium) to determine whether the available empirical evidence supported or refuted the theoretical expectations from the multi-level framework. Data were gathered using mixed methods, including structured face-to-face interviews, participant observations, documentation and a focus group. Multiple cases were analyzed performing a cross case synthesis to strengthen the results.

Results: The development of a care pathway across the primary-hospital care continuum, supported by a step-by-step scenario, led to the use of existing and newly constructed structures, data monitoring and the development of information tools. The construction and use of these inter-organizational mechanisms had a positive effect on exchanging information, formulating and sharing goals, defining and knowing each other's roles, expectations and competences and building qualitative relationships.

Conclusion: Care pathways across the primary-hospital care continuum enhance the components of care coordination.

Show MeSH
Related in: MedlinePlus