Clinical Pathways for Effective and Appropriate Care
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Purpose
The purposes of this study are to determine whether clinical pathways: 1)improve the quality of the care provided to patients affected by stroke in terms of clinical outcomes, efficiency continuity of care and patients' satisfaction; 2) facilitate the use of evidence based medicine in clinical practice.
| Condition | Intervention |
|---|---|
|
Stroke |
Other: Clinical Pathways |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Health Services Research |
| Official Title: | Diffusion of Clinical Pathways for the Implementation of Effective and Appropriate Care |
- Mortality [ Time Frame: 30 days after hospital admission ] [ Designated as safety issue: Yes ]
- Disability [ Time Frame: At hospital discharge ] [ Designated as safety issue: No ]
| Enrollment: | 448 |
| Study Start Date: | July 2005 |
| Study Completion Date: | May 2007 |
| Primary Completion Date: | May 2007 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
Patients treated according to clinical pathways
|
Other: Clinical Pathways
Clinical pathways are a methodology for the mutual decision making and organization of care for a well-defined group of patients during a well-defined period. Defining characteristics of clinical pathways includes: an explicit statement of the goals and key elements of care based on evidence, best practice, and patient expectations; the facilitation of the communication, coordination of roles, and sequencing the activities of the multidisciplinary care team, patients and their relatives; the documentation, monitoring, and evaluation of variances and outcomes; and the identification of the appropriate resources.
|
|
No Intervention: 2
Patients treated according to usual care
|
Detailed Description:
The coordination of care has been proved to be able to improve prognosis in acute stroke patients. Prompt identification of symptoms, organised timely and efficient transportation towards appropriate facilities, has become essential part of effective treatment, as well as organized rehabilitation. The importance of organized stroke care in facilitating recovery has been recognized for the last 10 years, but it is still unclear how organized care contributes to improved outcomes. Since clinical pathways aim to promote evidence- and guideline-based care, improve the organisation and efficiency of care, and reduce cost, their implementation may be a method for achieving the organizational standards required to grant appropriate care in stroke. Even though in the past decade, care pathways have been increasingly implemented as a tool in acute stroke care and stroke rehabilitation the evidence supports partially the use of clinical pathways in stroke because very little prospective controlled data demonstrated their effectiveness through the continuum of the care. Our study was designed in order to conduct a rigorous evaluation of clinical pathways for treatment of acute stroke patients in different types of organized stroke care.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Principal diagnosis of Ischemic Stroke (ICD9CM code 434.91)
Exclusion Criteria:
- Transient cerebral ischemia (ICD9CM code 435.9)
- Intracerebral hemorrhage (ICD9CM codes 431.xx)
Contacts and Locations| Study Chair: | Francesco Di Stanislao, MD | Agenzia Regionale Sanitaria delle Marche |
More Information
No publications provided by Agenzia Regionale Sanitaria delle Marche
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Andrea Gardini, Agenzia Regionale Sanitaria delle Marche |
| ClinicalTrials.gov Identifier: | NCT00673491 History of Changes |
| Other Study ID Numbers: | DCPIEAC-EXART12MARCHE |
| Study First Received: | May 5, 2008 |
| Last Updated: | May 6, 2008 |
| Health Authority: | Italy: Ministry of Health |
Keywords provided by Agenzia Regionale Sanitaria delle Marche:
|
Critical Pathways Stroke Randomized Controlled Trial Effectiveness |
Additional relevant MeSH terms:
|
Stroke Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases |
Nervous System Diseases Vascular Diseases Cardiovascular Diseases |
ClinicalTrials.gov processed this record on May 22, 2013