Integrated care pathways in neurosurgery: A systematic review.

<h4>Introduction</h4>Integrated care pathways (ICPs) are a pre-defined framework of evidence based, multidisciplinary practice for specific patients. They have the potential to enhance continuity of care, patient safety, patient satisfaction, efficiency gains, teamwork and staff educatio...

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Autores principales:	Keng Siang Lee, Stefan Yordanov, Daniel Stubbs, Ellie Edlmann, Alexis Joannides, Benjamin Davies
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ffadec92bd3b43ecb78edaa459a7d4b6
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spelling	oai:doaj.org-article:ffadec92bd3b43ecb78edaa459a7d4b62021-12-02T20:18:50ZIntegrated care pathways in neurosurgery: A systematic review.1932-620310.1371/journal.pone.0255628https://doaj.org/article/ffadec92bd3b43ecb78edaa459a7d4b62021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255628https://doaj.org/toc/1932-6203<h4>Introduction</h4>Integrated care pathways (ICPs) are a pre-defined framework of evidence based, multidisciplinary practice for specific patients. They have the potential to enhance continuity of care, patient safety, patient satisfaction, efficiency gains, teamwork and staff education. In order to inform the development of neurosurgical ICPs in the future, we performed a systematic review to aggregate examples of neurosurgical ICP, to consider their impact and design features that may be associated with their success.<h4>Methods</h4>Electronic databases MEDLINE, EMBASE, and CENTRAL were searched for relevant literature published from date of inception to July 2020. Primary studies reporting details of neurosurgical ICPs, across all pathologies and age groups were eligible for inclusion. Patient outcomes in each case were also recorded.<h4>Results</h4>Twenty-four studies were included in our final dataset, from the United States, United Kingdom, Italy, China, Korea, France, Netherlands and Switzerland, and a number of sub-specialties. 3 for cerebrospinal fluid diversion, 1 functional, 2 neurovascular, 1 neuro-oncology, 2 paediatric, 2 skull base, 10 spine, 1 for trauma, 2 miscellaneous (other craniotomies). All were single centre studies with no regional or national examples. Thirteen were cohort studies while 11 were case series which lacked a control group. Effectiveness was typically evaluated using hospital or professional performance metrics, such as length of stay (n = 11, 45.8%) or adverse events (n = 17, 70.8%) including readmission, surgical complications and mortality. Patient reported outcomes, including satisfaction, were evaluated infrequently (n = 3, 12.5%). All studies reported a positive impact. No study reported how the design of the ICP was informed by published literature or other methods.<h4>Conclusions</h4>ICPs have been successfully developed across numerous neurosurgical sub-specialities. However, there is often a lack of clarity over their design and weaknesses in their evaluation, including an underrepresentation of the patient's perspective.Keng Siang LeeStefan YordanovDaniel StubbsEllie EdlmannAlexis JoannidesBenjamin DaviesPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0255628 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Keng Siang Lee Stefan Yordanov Daniel Stubbs Ellie Edlmann Alexis Joannides Benjamin Davies Integrated care pathways in neurosurgery: A systematic review.
description	<h4>Introduction</h4>Integrated care pathways (ICPs) are a pre-defined framework of evidence based, multidisciplinary practice for specific patients. They have the potential to enhance continuity of care, patient safety, patient satisfaction, efficiency gains, teamwork and staff education. In order to inform the development of neurosurgical ICPs in the future, we performed a systematic review to aggregate examples of neurosurgical ICP, to consider their impact and design features that may be associated with their success.<h4>Methods</h4>Electronic databases MEDLINE, EMBASE, and CENTRAL were searched for relevant literature published from date of inception to July 2020. Primary studies reporting details of neurosurgical ICPs, across all pathologies and age groups were eligible for inclusion. Patient outcomes in each case were also recorded.<h4>Results</h4>Twenty-four studies were included in our final dataset, from the United States, United Kingdom, Italy, China, Korea, France, Netherlands and Switzerland, and a number of sub-specialties. 3 for cerebrospinal fluid diversion, 1 functional, 2 neurovascular, 1 neuro-oncology, 2 paediatric, 2 skull base, 10 spine, 1 for trauma, 2 miscellaneous (other craniotomies). All were single centre studies with no regional or national examples. Thirteen were cohort studies while 11 were case series which lacked a control group. Effectiveness was typically evaluated using hospital or professional performance metrics, such as length of stay (n = 11, 45.8%) or adverse events (n = 17, 70.8%) including readmission, surgical complications and mortality. Patient reported outcomes, including satisfaction, were evaluated infrequently (n = 3, 12.5%). All studies reported a positive impact. No study reported how the design of the ICP was informed by published literature or other methods.<h4>Conclusions</h4>ICPs have been successfully developed across numerous neurosurgical sub-specialities. However, there is often a lack of clarity over their design and weaknesses in their evaluation, including an underrepresentation of the patient's perspective.
format	article
author	Keng Siang Lee Stefan Yordanov Daniel Stubbs Ellie Edlmann Alexis Joannides Benjamin Davies
author_facet	Keng Siang Lee Stefan Yordanov Daniel Stubbs Ellie Edlmann Alexis Joannides Benjamin Davies
author_sort	Keng Siang Lee
title	Integrated care pathways in neurosurgery: A systematic review.
title_short	Integrated care pathways in neurosurgery: A systematic review.
title_full	Integrated care pathways in neurosurgery: A systematic review.
title_fullStr	Integrated care pathways in neurosurgery: A systematic review.
title_full_unstemmed	Integrated care pathways in neurosurgery: A systematic review.
title_sort	integrated care pathways in neurosurgery: a systematic review.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/ffadec92bd3b43ecb78edaa459a7d4b6
work_keys_str_mv	AT kengsianglee integratedcarepathwaysinneurosurgeryasystematicreview AT stefanyordanov integratedcarepathwaysinneurosurgeryasystematicreview AT danielstubbs integratedcarepathwaysinneurosurgeryasystematicreview AT ellieedlmann integratedcarepathwaysinneurosurgeryasystematicreview AT alexisjoannides integratedcarepathwaysinneurosurgeryasystematicreview AT benjamindavies integratedcarepathwaysinneurosurgeryasystematicreview
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Integrated care pathways in neurosurgery: A systematic review.

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