Background
Prevalence
Disease burden
Evidence based recommendations
Clinical pathways (CPWs)
Methods/design
Aims of the CPWs
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Identify and current best practices for the diagnosis and management of COPD;
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Use idenfied best practices in combination with local resources in the development of two CPWs;
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Tailor evidence-informed implementation strategies to the local context with the goal of encouraging uptake of the developed CPWs;
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Implement and pilot test the COPD pathway in two different Saskatchewan health regions; one urban (RQHR) and one in a rural (to be chosen at a later date);
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Evaluate the effectiveness of the CPWs based on chosen outcomes;
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Improve on areas of weakness identified through the evaluation
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Increase quality of care;
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Reduce healthcare utilization;
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Increase guideline adherence
Foundational activities
Implementation strategy
Implementation strategy | Description |
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Development | |
Clinician involvement | |
Evidence based interventions | |
Local consensus processes | Inclusion of participating providers in discussion to ensure that they agree that the chosen clinical problem is important and the approach to managing the problem is appropriate [34]. |
Analysis and Implementation Planning | |
Implementation team | |
Identification of potential barriers to change | |
Identification of practice gaps | Collection and analysis of data related to the need for the innovation; this assessment is used for: the description of usual care and its distance from evidence based care, outcomes of usual care, opinions from stakeholders on the needs for an innovation, and/or special considerations for delivering the innovation in the local context [24, 36]. |
Education | |
Local opinion leaders | |
Educational meetings | The participation of healthcare providers in conferences, lectures, workshops or traineeships [35]. |
Educational outreach | |
Printed educational materials | |
Systems | |
Audit and feedback | |
Reminders |
Key stakeholders
Name | Position |
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Sheila Anderson | Director, Primary Health Care, Kaizen Operations Team |
Margaret Baker | Executive Director Primary Health Care, Ministry of Health |
Bree Calland | Program Development Educator, Respiratory Services |
Patricia Comfort | Primary Health Care Manager, Chronic Disease Prevention and Management |
Lori Garchinski | Executive Director, Medicine |
Dr Rashaad Hansia | Urban Primary Health Care Physician Dyad Leader |
Shannon Jackson | Manager, Respiratory / Internal Medicine Unit, Regina General Hospital |
Rae-Lynn Lang | Manager of Therapies, Acute Care |
Taryn Lorenz | Director, Medicine |
Sheryl O’Quinn | Manager, Respiratory Services |
Dr Prakash Patel | Respirologist |
Erin Roesch | Director, Primary Health Care Decision Support |
Dr Shabaz Sheikh | Respirologist |
Roberta Weist | Director, HealthLine Saskatchewan |
Dr Fouche Williams | Rural Primary Health Care Physician Dyad Leader |
Tanya Winkel | Pharmacist, Acute Care |
Design
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Quality of care, measured by:
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○ Hospital readmission rates;
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○ Unscheduled visits (emergency department);
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Healthcare service utilization, measured by:
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○ Admissions rates;
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○ Length of stay;
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Adherence, measured by:
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○ Scheduled visits (primary care providers, specialists)
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