ICP Update 2005

Documents : Invasive Cardiology Final Draft (pdf file size 1.94MB)
CABG (pdf file 1.82MB)
don't have Adobe PDF Reader? - Click to download

 

'Chances of things going wrong are very high in the patient's journey due to the influences of each discipline'.

The team was brought together in July 2003 with the aim to develop, plan, design and implement Integrated Care Pathways (ICP's) in to the Heart Centre. We are a multidisciplinary team with a wide range of knowledge and experiences within both Cardiology and Cardiac Surgery.

What are ICP's and what difference will they make?

' A multidisciplinary process of patient focused care which specifies key events, tests and assessments occurring in a timely fashion to produce the best prescribed outcomes'

But what does this mean to us? It means less paperwork, involvement of all the multidisciplinary team and continuity of care. Everyone involved in the patient's journey will have access to all patient information including previous history, medical staff's notes, physiotherapy notes and nursing notes all in one document

Our aim is to provide a systematic, continuous improvement in practice and outcome for patients.

What is the point of ICP'S?

• Facilitate continuous quality improvement
  
• Improve patient outcomes
  
• Increase patient involvement in care
  
• Improve teamwork by multiple disciplines
  
• Improve consistency in care
  
• Improve resource management
  
• Assist in developing risk management strategies
  

 

How will an ICP help us?

• They provide a systematic approach to looking at a patient's journey, experience and expectations.
  
• Provide easier data collection and variations in care are highlighted for investigation and action
  
• Work towards all patients receiving the same or similar treatments

 

Why take on such a project?

We already provide an excellent service to our clients - but can we prove it. Integrated Care Pathways can be used as a tool to improve our service, obtain data for research & audit purposes, improve communication between team members and incorporate the patients & their relatives into their treatment and care.
Patients deserve the best service we can provide which is backed up with protocols and evidence based practice.

As we are all aware there are currently a number of NHS initiatives aimed at improving the quality of health care.

These include:

• National Service Frameworks
  
• Evidence based Health Care
  
• Clinical Effectiveness
  
• Continuous quality improvement through benchmarking
  
• Clinical Governance
  
• Essence of care
  
• National performance Frameworks
  
• The NHS Plan

Integrated Care Pathways can be seen as one way of implementing these initiatives into everyday clinical practice.

 

Why do we want them?

• To improve patient experience/expectations
  
• There is the potential to reduce financial costs to the directorate & trust
  
• Improve working relationships between disciplines
  
• ICP's impact on the '7' pillars of Clinical Governance
  
• Assist in modernisation of our service to the clients

What have the team done?

• Collected data from other Trusts already using ICP's and formulated our likes and dislikes list
  
• Collected evidence based practice to support protocols and guidelines already in use
  
• Process mapped patient journeys
  
• Held an open day to provide information to others about the concept - more have already been booked

Our Six Month Aim:

• Design our Integrated Care Pathway - obtain approval for use from management team, medics, nursing staff et al & medical records
  
• Complete a baseline audit following patients on their journey through the Heart centre
  
• Obtain medical input and support for the project
  
• Instigate a rolling teaching programme open to all
  
• Completed a pilot study following the introduction of our 'Invasive Cardiology ICP'
  
• Commence development of further pathways.

 

What research supports this principle?

• There is little evidence of the effectiveness of ICP's as a concept (Currie & Harvey 1997)
  
• But in 1998 ~ 280 NHS trusts were either developing or using pathways in the UK ( Currie 1998)
  
• Pathways have gained formal recognition from the Department of Health (1998)

The ICP team are proposing to perform baseline audits in relation to the patients journey and experience prior to the introduction of the pathway and then re-visit these areas when the pathways is in use and re-audit to demonstrate any improvements in the journey.
We hope to look at highlighted areas of concern such as length of stay, fasting times, and delays in the system, duplication of information etc.

Areas in which we will be developing a pathway:

1) Invasive Cardiology - to include all procedures performed in the Catheter Lab
2) Acute Coronary Syndrome
3) Myocardial Infarction
4) Unstable Angina
5) Coronary Artery By-Pass Grafting
6) Valve replacements
7) Thoracic Procedures
8) Heart Failure

If there are areas in which we could develop a pathway please let any of the team know and we will look into it.