European Quality of Care Pathways Study on the Effect of Care Pathways on Interprofessional Teamwork (EQCP-TEAM)
Care pathways are complex interventions to support the interprofessional team in the redesign of their care process. This international cluster randomised trial will analyse the impact of the development and implementation of care pathways on the interprofessional teamwork.
Chronic Obstructive Pulmonary Disease
Proximal Femur Fracture
Behavioral: Care pathway.
|Study Design:||Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Health Services Research
|Official Title:||The Impact of Care Pathways on Interprofessional Teamwork: an International Cluster Randomized Controlled Trial|
- Relational Coordination [ Time Frame: For average period of 3 months ] [ Designated as safety issue: Yes ]Relational coordination describes the quality of communication and functional relations within a interprofessional team with shared goals and interdependent tasks.
- Perceived Organisation of Care [ Time Frame: For average period of 3 months ] [ Designated as safety issue: Yes ]The perceived organisation of care is a team indicator to measure the actual organisation of the care process. It is measured in a valid and reliable way by using the Care Process Self Evaluation Tool (CPSET).
- Work engagement [ Time Frame: For average period of 3 months ] [ Designated as safety issue: Yes ]Work engagement is a measure to analyse the level of competence, emotional exhaustion and mental detachement measured with the Burnout Inventory.
- Team Climate [ Time Frame: For average period of 3 months ] [ Designated as safety issue: Yes ]Team climate is an indicator to measure the team vision, participative safety, support for innovation and task orientation.
|Study Start Date:||May 2009|
|Estimated Study Completion Date:||December 2013|
|Estimated Primary Completion Date:||December 2013 (Final data collection date for primary outcome measure)|
Experimental: Care pathway teams.
In this experimental arm, the interprofessional teams will develop and implement a care pathways.
Behavioral: Care pathway.
The intervention group will implement a care pathway for PFF or COPD containing three active components: a formative evaluation of the actual teams' performance, a set of evidence based key interventions and a training in pathway-development.
No Intervention: Usual care teams.
In the no intervention arm, the interprofessional teams will deliver usual care without implementing the intervention.
Background Although care pathways are often said to promote teamwork, high-level evidence that supports this statement is lacking. The objective of the European Quality of Care Pathway (EQCP) study is therefore to study the impact of care pathways on interprofessional teamwork.
Methods/design An international post-test-only cluster Randomized Controlled Trial (cRCT), combined with process evaluations, will be performed in Belgium, Ireland, Italy and Portugal. Teams caring for Proximale Femur Fracture (PFF) patients and patients hospitalized with an exacerbation of Chronic Obstructive Pulmonary Disease (COPD) will be randomized into an intervention and control group. The intervention group will implement a care pathway for PFF or COPD containing three active components: a formative evaluation of the actual teams' performance, a set of evidence based key interventions and a training in pathway-development. The control group will provide usual care. As effect measures a set of team input, process and output indicators will be used. Main outcome indicator is the team process indicator relational coordination. Next to these, process measures will be used to evaluate the implementation process. In total, 132 teams agreed to participate, of which 68 were randomly assigned to the intervention group and 64 to the control group. Based on power analysis, a sample of 475 team members per arm is required. To analyze results, multilevel analysis will be performed.
Discussion The EQCP-study on teamwork is the first cluster-randomized controlled trial on the impact of care pathways on interprofessional teamwork. Results from our study will enhance understanding on the active components of care pathways. Through this, preferred implementation strategies can be defined.
|Katholieke Universiteit Leuven|
|Leuven, Belgium, 3000|
|Study Director:||Kris Vanhaecht, PhD||Katholieke Universiteit Leuven|
|Principal Investigator:||Walter Sermeus, PhD||Katholieke Universiteit Leuven|
|Principal Investigator:||Massimiliano Panella, PhD||Amedeo Avogadro University of Eastern Piemont|
|Principal Investigator:||Svin Deneckere, MSc||Katholieke Universiteit Leuven|