The Belgian Dutch Clinical Pathway Network: CPs and knowledge sharing on the Importance of Continuous Quality Improvement Prof. Dr. Walter Sermeus Director Belgian Dutch Clinical Pathway Network Board Member European Pathway Association Center for Health Services and Nursing Research, Catholic University Leuven, Belgium 1
Brussels 25 km Leuven Town Hall University Hall www.kuleuven.be www.leuven.be 2
Flemish Speaking Part Belgium & The Netherlands Prof. Dr. Walter Sermeus Prof. Dr. Arthur Vleugels Prof. Dr. Karel De Witte Roeland Depreitere Kris Vanhaecht Leentje De Bleser Pieter Van Herck The Netherlands Ruben Van Zelm Evelien Klokman Mona van de Steeg Theus Van Barneveld French Speaking Part Belgium Prof. Dr. E. Darras Nathalie Chaidron David Sauwens Dr. Xavier de Béthune 3
Members Belgian Dutch Clinical Pathway Network 2005 Sint Niklaas Maria Middelares Dendermonde St Blasius Gent St. Lucas Maria Middelares Oostende Damiaan H. Serruys BZIO Den Haag Hagaziekenhuis Rotterdam Oogziekenhuis Roeselare Ieper H.Hart J.Yperman Kortrijk Groeninge Zottegem Sint Elisabeth Ronse Zusters van Barmhartigheid Beverwijk Rode Kruis ZH Brugge St. Jan Sint Lucas Wit gele Kruis W-VL Aalst Stedelijk Ziekenhuis OLV Ziekenhuis Turnhout St. Elisabeth Sint Jozef Amsterdam Antoni Van Leeuwenhoek Brasschaat Klina Deinze St.Vincentiusziekenhuis Vilvoorde Jan Portaels Halle Sint Maria Mechelen- Duffel Sint Maarten Bonheiden Imelda Dordrecht A. Schweitzer Brussel WG Kruis Melsbroek MS Centrum Almelo Twenteborg Antwerpen Sint Augustinus UZ Antwerpen ZNA Hof Ter Schelde Sint Vincentius WGK Antwerpen Herentals Deurne Geel St. Elisabeth Vzw Monica St Dimpna Genk Overpelt Heusden MS Centrum ZOL St Fransiscus WG Kruis Limburg Hasselt Virga Jesse Salvator/ Sint Ursula Sittard Eupen St Nikolaus Malle Sint Jozef Sint Truiden Sint Trudo Tongeren Leuven Vesalius Universitaire Ziekenhuizen Wit Gele Kruis VL- Brabant Nieuwegein St. Antonius Orbis Heerlen Atrium Maastricht Acad. Ziekenhuis 4
Members via CBO/UCL Bruxelles St Luc Bruxelles Cliniques de l Europe Tournai CHR Delft Reinier de Graaf Spijkenisse Ruwaard van Putten Den Haag MC Den Haag Nivelles CH de Tubize-Nivelles La Louvière CH de Jolimont Lobbes Leiden Diaconessenhuis Amsterdam OLV Gasthuis VUMC Hoorn Westfries Gasthuis Leeuwarden Medisch Centrum Heerenveen Tjongerschans Groningen Academisch Ziekenhuis Hilversum KBCZ Amersfoort Meander MC Enschede Medisch Spectrum Winterswijk Koningin Beatrix Tiel Ziekenhuis Rivierland Liège CHC Gosselies Notre Dame de Grâce Godinne CliniqueUniversitaire. Mt Godinne Libramont Centre hospitakier de l Ardennes Réseau Itinéraire Cliniques 5
NKP Members July 2005 Belgium The Netherlands TOTAL Acute Hospitals 48 38 Flemish Speaking 9 French Speaking 1 German Speaking 25 73 Rehab Centres 4 BZIO, Hof Ter Schelde, MS Melsbroek MS Overpelt 0 4 Primary Care Organisations 5 WGK Federatie WGK Vlaams Brabant WGK West Vlaanderen WGK Limburg WGK Antwerpen 0 5 82 6
Activities of Belgian Dutch Clinical Pathway Network Hospital: -Steering Group -Co-ordinator -Facilitator GENERAL ASSEMBLY DAILY MANAGEMENT TEAM CZV/CBO/UCL -Co-ordination -Methods -Networking EDUCATION: - 3 day introduction - 10 day facilitator course - 3 monthly introduction (1/2 day) - 6 monthly introduction for MDs - In house training MEETINGS: -Co-ordinators -Facilitators -Ad Hoc (specific topics) TASK FORCES: -Clinical (benchmarking) -Peer review: rehab, palliative, psychiatry, primary care -Strategic Management -Financing -ICT (Ad Hoc) -Survey development (Ad Hoc) RESEARCH: -CP Self Evaluation Tool -Management Accounting -Operations Management -Link Patient Safety & Risk -EBM -ICT -Teamwork 7
1 CPW Definition for 82 organisations in 2 countries It is a collection of methods and tools to guide the members of a multidisciplinary and interdisciplinary team towards patient focussed collaboration for a specific patient population. It is a way of identifying and defining the different tasks of the different team members. The goal is to assure qualitative and efficient care. It is a tool to systematically plan and follow-up a patient focussed care programme. Sermeus & Vanhaecht, 2003 8
1 Scenario to Develop, Implement and Evaluate Clinical Pathways 30 step P-D-C-A cycle Vanhaecht & Sermeus, 2003 Plan Phase: identify patient population, team, first version, expected outcomes Act Phase: evaluation implementation Do Phase: facts and figures on actual care and best-practice Check/Study Phase: interpreting data (do phase) developing second version of CPW based on findings 9
1 Framework to evaluate CP Leuven Clinical Pathway Compass Vanhaecht & Sermeus, Journal of Integrated Care Pathways, 2003, 7, 2-7 Bill of Services ABC Clinical pathway specific outcomes Financial Domain Clinical Domain Variance Tracking Process analysis Process Domain Team Domain Service Domain The Leuven Clinical Pathway Compass, CZV-KULeuven, 2002a Patient satisfaction Fry: goals, roles, procedures and relations 10
1 Database on CPW projects (n=450) 11
1 Strategy Strategic Level of BDCPW Network Contract between partners Contract Healthcare Organisation University Signed by CEO of organisation Signed by Director of Partner (CZV-CBO-UCL) 3 year contract Annual fee of 5500 Win Win relation University has methodological know-how Joint Venture between CZV-CBO-UCL Organisations have know-how in clinical field 12
1 GOAL: Knowledge Sharing Clinical Pathway Process Clinical Pathway Document 13
More Information www.nkp.be 14