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The Belgian Dutch Clinical Pathway Network:

CPs and knowledge sharing on the Importance of Continuous Quality Improvement

Prof. Dr. Walter SermeusDirector Belgian Dutch Clinical Pathway Network

Board Member European Pathway AssociationCenter for Health Services and Nursing Research, Catholic University Leuven, Belgium

© Belgian Dutch Clinical Pathway Network, 2005

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Brussels

Leuven

Town Hall University Hall

25 km

www.kuleuven.bewww.leuven.be

© Belgian Dutch Clinical Pathway Network, 2005

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Flemish Speaking Part Belgium& The Netherlands

Prof. Dr. Walter SermeusProf. Dr. Arthur VleugelsProf. Dr. Karel De Witte

Roeland Depreitere Kris Vanhaecht

Leentje De BleserPieter Van Herck

The NetherlandsRuben Van ZelmEvelien Klokman

Mona van de SteegTheus Van Barneveld

French Speaking Part BelgiumProf. Dr. E. DarrasNathalie Chaidron

David SauwensDr. Xavier de Béthune

© Belgian Dutch Clinical Pathway Network, 2005

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OostendeDamiaan

H. SerruysBZIO

KortrijkGroeninge

RoeselareH.Hart

BruggeSt. JanSint LucasWit gele Kruis W-VL

AalstStedelijk Ziekenhuis

OLV Ziekenhuis

Antwerpen

ZNASint Augustinus

LeuvenUniversitaire ZiekenhuizenWit Gele Kruis VL- Brabant

GenkZOLWG Kruis Limburg

HasseltVirga JesseSalvator/ Sint Ursula

BonheidenImelda

TongerenVesalius

AmsterdamAntoni Van Leeuwenhoek

AlmeloTwenteborg

SittardOrbis

St Dimpna

GentSt. Lucas

Maria Middelares

Geel

TurnhoutSt. ElisabethSint Jozef

ZottegemSint Elisabeth

St NikolausEupen

Sint NiklaasMaria Middelares

DendermondeSt Blasius

RonseZusters van Barmhartigheid

DordrechtA. Schweitzer

MalleSint Jozef

NieuwegeinSt. Antonius

Den HaagHagaziekenhuis

RotterdamOogziekenhuis

Mechelen- DuffelSint Maarten

BrusselWG Kruis

Sint TruidenSint Trudo

UZ AntwerpenHof Ter ScheldeWGK Antwerpen

BrasschaatKlina

MelsbroekMS Centrum

MaastrichtAcad. Ziekenhuis

HeerlenAtrium

MS CentrumOverpelt

Sint VincentiusDeurneVzw MonicaDeinze

St.VincentiusziekenhuisHeusden

St FransiscusIeperJ.Yperman

BeverwijkRode Kruis ZH

HerentalsSt. Elisabeth

Members Belgian Dutch Clinical Pathway Network 2005

HalleSint Maria

VilvoordeJan Portaels

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RéseauRéseau ItinéraireItinéraire CliniquesCliniques

Bruxelles

Centre hospitakier de l’Ardennes

St Luc

GodinneCliniqueUniversitaire.Mt Godinne

Cliniques de l’Europe

Bruxelles

Libramont

NivellesCH de Tubize-Nivelles

TournaiCHR

GosseliesNotre Dame de Grâce

CHCLa LouvièreCH de Jolimont Lobbes

Liège

DelftReinier de Graaf

Ruwaard van PuttenSpijkenisse

LeidenDiaconessenhuis Amsterdam

OLV GasthuisVUMC

HoornWestfries Gasthuis

LeeuwardenMedisch Centrum

HeerenveenTjongerschans

Meander MCAmersfoort

EnschedeMedisch Spectrum

WinterswijkKoningin Beatrix

Den HaagMC Den Haag

HilversumKBCZ

TielZiekenhuis Rivierland

GroningenAcademisch Ziekenhuis

Members via CBO/UCL

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NKP Members

505

WGK FederatieWGK Vlaams BrabantWGK West Vlaanderen

WGK LimburgWGK Antwerpen

Primary Care Organisations

404BZIO, Hof Ter Schelde, MS Melsbroek

MS Overpelt

RehabCentres

732548

38 Flemish Speaking9 French Speaking1 German Speaking

Acute Hospitals

TOTALThe

NetherlandsBelgium

July 2005

82© Belgian Dutch Clinical Pathway Network, 2005

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Hospital:-Steering Group

-Co-ordinator-Facilitator

CZV/CBO/UCL-Co-ordination

-Methods-Networking

GENERAL ASSEMBLY

DAILY MANAGEMENT TEAM

EDUCATION:- 3 day introduction

- 10 day facilitator course- 3 monthly introduction (1/2 day)- 6 monthly introduction for MDs’

- In house training

MEETINGS:-Co-ordinators

-Facilitators-Ad Hoc (specific topics)

TASK FORCES:-Clinical (benchmarking)

-Peer review: rehab, palliative, psychiatry, primary care-Strategic Management

-Financing-ICT (Ad Hoc)

-Survey development (Ad Hoc)

RESEARCH:-CP Self Evaluation Tool-Management Accounting-Operations Management-Link Patient Safety & Risk

-EBM-ICT

-Teamwork

Activities of Belgian Dutch Clinical Pathway Network

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1 CPW Definition for 82 organisations in 2 countries

• It is a collection of methods and tools to guide themembers of a multidisciplinary andinterdisciplinary team towards patient focussedcollaboration for a specific patient population. It isa way of identifying and defining the differenttasks of the different team members.

• The goal is to assure qualitative and efficient care.• It is a tool to systematically plan and follow-up a

patient focussed care programme. Sermeus & Vanhaecht, 2003

© Belgian Dutch Clinical Pathway Network, 2005

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Plan Phase:

identify patient population, team, first version, expected

outcomes

Do Phase:

facts and figures on actual care and best-practice

Check/Study Phase:

interpreting data (do phase) developing second version of CPW

based on findings

Act Phase:

evaluation

implementation

1 Scenario toDevelop, Implement and Evaluate Clinical Pathways

30 step P-D-C-A cycleVanhaecht & Sermeus, 2003

© Belgian Dutch Clinical Pathway Network, 2005

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1 Framework to evaluate CPLeuven Clinical Pathway Compass

Vanhaecht & Sermeus, Journal of Integrated Care Pathways, 2003, 7, 2-7

Bill of ServicesABC

Variance TrackingProcess analysis

Fry: goals, roles, procedures and relations

Patient satisfaction

Clinical pathwayspecific outcomes

Clinical Domain

Service Domain

FinancialDomain

ProcessDomain

Team Domain

© The Leuven Clinical Pathway Compass, CZV-KULeuven, 2002a

© Belgian Dutch Clinical Pathway Network, 2005

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1 Database on CPW projects(n=450)

© Belgian Dutch Clinical Pathway Network, 2005

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1 Strategy• Strategic Level of BDCPW Network

– Contract between partners– Contract Healthcare Organisation – University

• Signed by CEO of organisation• Signed by Director of Partner (CZV-CBO-UCL)

– 3 year contract– Annual fee of 5500€

• Win – Win relation– University has methodological know-how– Joint Venture between CZV-CBO-UCL– Organisations have know-how in clinical field

© Belgian Dutch Clinical Pathway Network, 2005

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1 GOAL: Knowledge Sharing

Clinical Pathway Document

Clinical Pathway Process

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More Information

www.nkp.be

© Belgian Dutch Clinical Pathway Network, 2005