The European quality of care pathways (EQCP) study on the impact of care pathways on interprofessional teamwork in an acute hospital setting: study protocol: for a cluster randomised controlled trial and evaluation of implementation processes
1 Public Health School, Faculty of Medicine, KU Leuven, Kapucijnenvoer, Leuven, Belgium
2 Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat, Leuven, Belgium
3 European Pathway Associa0074ion, Kapucijnenvoer, Leuven, Belgium
4 Faculty of Medicine, Amedeo Avogadro University of Eastern Piedmont, Via Duomo, Vercelli, Italy
5 Western Norway Research Network on Integrated Healthcare Helse Fonna, Haugesund, Norway
Implementation Science 2012, 7:47 doi:10.1186/1748-5908-7-47Published: 18 May 2012
Although care pathways are often said to promote teamwork, high-level evidence that supports this statement is lacking. Furthermore, knowledge on conditions and facilitators for successful pathway implementation is scarce. The objective of the European Quality of Care Pathway (EQCP) study is therefore to study the impact of care pathways on interprofessional teamwork and to build up understanding on the implementation process.
An international post-test-only cluster Randomised Controlled Trial (cRCT), combined with process evaluations, will be performed in Belgium, Ireland, Italy, and Portugal. Teams caring for proximal femur fracture (PFF) patients and patients hospitalized with an exacerbation of chronic obstructive pulmonary disease (COPD) will be randomised 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 care pathway-development. The control group will provide usual care. A set of team input, process and output indicators will be used as effect measures. The main outcome indicator will be relational coordination. Next to these, process measures during and after pathway development will be used to evaluate the implementation processes. In total, 132 teams have 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.
Results from our study will enhance understanding on the active components of care pathways. Through this, preferred implementation strategies can be defined.