Journal Article

Evaluation of the impact of a clinical pathway on the organization of a multidisciplinary dental sleep clinic

Vanderveken, O. M., Braem, M. J., Van de Heyning, P. H., Altenburg, A., Vanhaecht, K., Dieltjens, M., Ten Berge, D. M.

2014

Overview

Purpose Clinical pathways are used to organize complex care processes by providing structure and standardization. The multidisciplinary approach of oral appliance (OA) therapy for sleep-disordered breathing (SDB) is a complex and dynamic process suitable for such a structured pathway approach. Methods A clinical pathway for patients referred for OA therapy was developed and implemented. The aim of this study was to evaluate the impact of this clinical pathway on the time to delivery of the OA and the organization of the multidisciplinary dental sleep clinic (MDSC). The latter was achieved using the care process self-evaluation tool (CPSET). Results First, development and implementation of the clinical pathway gave structure and shortened the mean time to delivery by 102 days (240 ± 70 vs. 138 ± 33 days) (Mann–Whitney U : P  < 0.001). Second, the CPSET scores were obtained in a cohort of 49 healthcare professionals involved in the pathway. Overall, patient-focused organization received the highest scores (80.5 ± 9.0 %), whereas cooperation with primary care received the lowest score (66.7 ± 12.4 %). Conclusions This is the first project on clinical pathways in OA therapy for SDB. The implementation of the pathway in our MDSC has created a significant shortening of the time to delivery. A first evaluation of the clinical pathway using the CPSET scores indicates that all disciplines involved should be thoroughly informed in an ongoing approach.

• Publisher: Springer Berlin Heidelberg,Springer,Springer Nature B.V
• Subject: Adult / Aged / Airway management / Belgium / Biological and medical sciences / Clinical pathways / Cooperation / Cooperative Behavior / Critical Pathways - organization & administration / Delivery of Health Care - organization & administration / Dental Clinics - organization & administration / Dentistry / Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes / Evaluation / Female / Fundamental and applied biological sciences. Psychology / Health care / Health services / Humans / Injuries of the nervous system and the skull. Diseases due to physical agents / Interdisciplinary aspects / Interdisciplinary Communication / Internal Medicine / Male / Mandibular Advancement - instrumentation / Medical personnel / Medical sciences / Medical treatment / Medicine / Medicine & Public Health / Middle Aged / Mouth / Nervous system (semeiology, syndromes) / Neurology / Original Article / Orthodontic Appliances / Otorhinolaryngology / Patient Care Team - organization & administration / Patient-Centered Care - organization & administration / Patients / Pediatrics / Pneumology / Pneumology/Respiratory System / Primary care / Quality of Health Care - organization & administration / Respiratory system : syndromes and miscellaneous diseases / Self evaluation / Sleep / Sleep apnea / Sleep Apnea, Obstructive - diagnosis / Sleep Apnea, Obstructive - therapy / Sleep disorders / Sleep. Vigilance / Standardization / Therapy / Traumas. Diseases due to physical agents / Vertebrates: nervous system and sense organs / Young Adult