Programme no. 266-P
Feasibility of implementation of care pathways in Finland at Pirkanmaa health centers
Leena Kuusisto*1, Elise Kosunen2, Doris Holmberg-Marttila3, Mika Palvanen*4
1Centre of General Practice,Pirkanmaa Hospital District,Tampere,Finland, 2School of Medicine,University of Tampere,Tampere,Finland, 3Centre of General Practice,Pirkanmaa Hospital District,Tampere,Finland, 4Centre of General Practice,Pirkanmaa Hospital District,Tampere,Finland
* = Presenting author
Objectives: The aim of this study was to assess the implementation of the care pathways at Pirkanmaa health centers concentrating to the above mentioned care pathways, and to assess the knowledge and the utilization of the new patterns of work developed for the patient centered care and health impact.
Background: The role of the Centre of General Practice in the Pirkanmaa Hospital District is to support implementation of regional care pathways. The focus of the implementation has been on care pathways that aim to change practice of professionals and patients, such as care pathways of patients with multimorbidity or sudden heart disease. The development object with respect to the first pathway has been health impact (Chronic Care Model) and the object for the second pathway patient centered care.
Results: The study revealed that the main implementation method of care pathways is the provision of information, but there is no agreed process for handling the care pathways together. It is left to the discretion of each professional to familiarize himself/herself with and utilize a care pathway. Professionals have a positive attitude to the patient centered care. They consider patient segmentation as a solution to the effective allocation of services and as a way to ensure that there will be sufficient resources in the future. While there are lots of services available, they are utilized arbitrarily. There is a need for tools to ensure patient segmentation. Professionals are focused on the activities of their own units, not on the patient’s entire care process. Proactive practices have been developed, but professionals are not utilizing them enough. The organization culture of health centers does not yet include the concept of active care.
Material/Methods: The study took the form of a questionnaire which was sent to the health centers. Subsequently, the medical director and expert nurse from the Centre of General Practice visited them. During the visits the questionnaire answers were discussed with medical directors, head nurses and clinicians. Every health center returned one completed questionnaire, representing the consensus opinion of the participants of the meeting. In total, 27 completed questionnaires were received between August 2013 and January 2014.
Conclusion: The questionnaire produced comparison data to support management, development and collaboration efforts. The audit itself also constituted an intervention. The results of the questionnaire and the suggested actions were considered together with the health centers during feedback visits in autumn 2014. The questionnaire will be repeated in autumn 2015.
Points for discussion: implementation of care pathways, patient centered care, health impact