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The overall admission rate decreased from 63% (2898/4595) to 60% (819/1363) [p < 0.05] in comparison to a cohort studied prior to pathway implementation.
A survey of 17 European countries, for example, found that the influence of external bodies (such as purchasers), lack of encouragement and financial support for pathway development, and payment incentives to be the most commonly reported organisational or external constraint to pathway implementation [ 29].
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In particular we aim to identify which factors facilitate or present barriers to care pathway implementation.
This is the first study specific to a clinical pathway implementation in psychosocial oncology to formally document such themes using a qualitative approach.
Ownership by the team was initially perceived as a barrier, but as the interviews progressed, many participants became more positive in their views that an engaged team that was willing to shape and lead pathway implementation could work cooperatively to overcome known barriers.
Bearing the above sub process components in mind, the authors pre-calculated an expectable sub process cost sum of 4500 €, which was hoped to reduce to 4000 € after clinical pathway implementation.
Even with the increased volume the patient satisfaction rose from 56% at the time of pathway implementation to 77% at the end of the evaluation period of 45 months.
Our objectives are: 1) to determine the extent to which nursing interventions in care pathway implementation converge with demands for greater integration of care and services; and 2) to determine the extent to which nursing practice is at similar or different phases of development in the integration process in different care pathways.
Whether this gradient in preopative index distributions is rather an indication of intervention-related bias in the above meaning or rather represents a consequence of different recruitement patterns among the pre and post pathway implementation cohorts (related to the willingness to attend briefings) cannot be quantified by means of the data at hand.
The sub cohort of patients without patient information/education, however, showed a locally significant cost reduction (median cost sums 4149 € versus 4303 €, Wilcoxon p = 0.001) in comparison to the first cohort before pathway implementation, but no difference concerning clinical outcome (median WOMAC increase 38% versus 39%, Wilcoxon p = 0.650).
To assess the effect of enhanced recovery pathway implementation on patient outcomes after vaginal hysterectomy (VH) performed to treat benign indications.
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