Diffusion of Clinical Pathways for the Implementation of Effective and Appropriate Care
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Stroke
- Sponsor
- Agenzia Regionale Sanitaria delle Marche
- Enrollment
- 448
- Primary Endpoint
- Mortality
- Status
- Completed
- Last Updated
- 17 years ago
Overview
Brief Summary
The purposes of this study are to determine whether clinical pathways: 1)improve the quality of the care provided to patients affected by stroke in terms of clinical outcomes, efficiency continuity of care and patients' satisfaction; 2) facilitate the use of evidence based medicine in clinical practice.
Detailed Description
The coordination of care has been proved to be able to improve prognosis in acute stroke patients. Prompt identification of symptoms, organised timely and efficient transportation towards appropriate facilities, has become essential part of effective treatment, as well as organized rehabilitation. The importance of organized stroke care in facilitating recovery has been recognized for the last 10 years, but it is still unclear how organized care contributes to improved outcomes. Since clinical pathways aim to promote evidence- and guideline-based care, improve the organisation and efficiency of care, and reduce cost, their implementation may be a method for achieving the organizational standards required to grant appropriate care in stroke. Even though in the past decade, care pathways have been increasingly implemented as a tool in acute stroke care and stroke rehabilitation the evidence supports partially the use of clinical pathways in stroke because very little prospective controlled data demonstrated their effectiveness through the continuum of the care. Our study was designed in order to conduct a rigorous evaluation of clinical pathways for treatment of acute stroke patients in different types of organized stroke care.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Principal diagnosis of Ischemic Stroke (ICD9CM code 434.91)
Exclusion Criteria
- •Transient cerebral ischemia (ICD9CM code 435.9)
- •Intracerebral hemorrhage (ICD9CM codes 431.xx)
Outcomes
Primary Outcomes
Mortality
Time Frame: 30 days after hospital admission
Secondary Outcomes
- Disability(At hospital discharge)