What is a Care Pathway?

1
What is a Care Pathway?
Ali El-Ghorr Implementation Advisor
2
Overview of presentation

• Different types of care pathways
• How to develop an ICP for BPD
• Example mental health ICP

3
Lesbian Vampire Killers
4
(No Transcript)
5
(No Transcript)
6
(No Transcript)
7
PathwayAlgorithmReferral PathwayProtocolCare
PathwayPatient PathwayTriage PathwayService
PathwayGuidelineCritical PathwayIntegrated
Care Pathway
Whats in a name?
8
AlgorithmCare PathwayIntegrated Care Pathway
9
Algorithm

• Decision aid
• One page summary
• Based on evidence
• Layed out as a decision tree
• Usually used by 1 professional in the care of 1
  individual
• Clinical judgement still important

10
ExampleAlcohol Screening and Brief
Interventions Algorithm
11
(No Transcript)
12
Care Pathway
13
Care Pathway

• Diagrammatic representation of a journey of care
• Multidisciplinary
• High level map of care
• Based on evidence and good practice
• Includes all main referral routes referral
  criteria
• Describes who is responsible for what
• Includes main comorbidities and complications
• Applies to 80 cases

14
(No Transcript)
15
What is an Integrated Care Pathway (ICP)?
16
Integrated Care Pathway
A system of care that allows the comparison of
planned care with care actually given
17
Integrated Care Pathways

• Focus on the service user
• Part of the care record
• Map out the expected care (multidisciplinary/multi
  -agency)
• Describe how care should be structured and
  co-ordinated
• Set standards along the care journey based on the
  evidence best practice
• Facilitate the monitoring of these standards
  through VARIANCE tracking

18
Mental HealthICPs
19
Policy Context
Delivering for Mental Health (Dec 2006)

• National policy to improve mental health services
  through development and implementation of
  Integrated Care Pathways

20
The Healthcare Quality Strategy for NHSScotland

• Person-centred
• Safe
• Effective

21
QIS standards
22
ICP Standards
23
How do you develop an ICP for BPD?
24
Process Standards
Process mapping
Stakeholder involvement
25
Delivering together
Local Teams
GPs

26
Involving Primary Care
27
Possible incentives

• ICP links to Quality Outcomes Framework
  Mental health register
• Physical health checks
• Dementia review
• Depression screening
• Depression assessment using validated tool
• ICPs linked to psychological therapies HEAT target

28
Process Mapping
High level
29
(No Transcript)
30
Opportunity for Redesign
31
Content
32

• Service user at the centre of care planning
• Comprehensive assessment
• Risk management
• A service user rated measure of needs (eg Avon)
• Targeted inpatient admission
• Measure outcome

33

• There is a record of medication for BPD

34
(No Transcript)
35
ExampleNHS Tayside mental health admission and
discharge ICP
36
Admission Discharge ICP
37
(No Transcript)
38
(No Transcript)
39
(No Transcript)
40
(No Transcript)
41
(No Transcript)
42
(No Transcript)
43
(No Transcript)
44
(No Transcript)
45
(No Transcript)
46
(No Transcript)
47
(No Transcript)
48
(No Transcript)
49
Implementation
50
Local implementation

• Part of local strategy
• Identify local champions / leads
• Embed ICP work within Care Governance
• Conduct awareness raising education
• Repeat education programme
• Audit, review provide feedback

51
Support available

• National ICP toolkit (www.icptoolkit.org)
• Network of National ICP Co-ordinators ICP Team
• BPD Network
• Co-ordinated approach (Health Directorates, NHS
  Education Scotland, Social Work, Care Commission
  and others)

52
Incentives

• Quality strategy (person centred, safe,
  effective)
• Patient safety in mental health
• HEAT targets in mental health
• Quality Outcomes Framework
• Partnership working (Social Work Voluntary
  Sector
• ICP accreditation

53
Conclusions

• Different types of care pathways
• ICPs are a system of care
• ICPs are a tool for service redesign and
  continuous quality improvement
• Focus on service user and meeting their needs
• Support and help is available

54
www.icptoolkit.org
55
Welcome to the Scottish Personality Disorder
Network ConferenceThursday 17th March 2011
SCOTTISH Personality Disorder NETWORK