Clinical Pathways for Effective and Appropriate Care

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.

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Key information

Conditions

Stroke Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Nervous System Diseases Vascular Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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)

Treatment and study plan

Clinical Pathways

Other

Clinical pathways are a methodology for the mutual decision making and organization of care for a well-defined group of patients during a well-defined period. Defining characteristics of clinical pathways includes: an explicit statement of the goals and key elements of care based on evidence, best practice, and patient expectations; the facilitation of the communication, coordination of roles, and sequencing the activities of the multidisciplinary care team, patients and their relatives; the documentation, monitoring, and evaluation of variances and outcomes; and the identification of the appropriate resources.

Primary outcomes

Mortality

Time frame: 30 days after hospital admission

Secondary outcomes

Disability

Time frame: At hospital discharge

Sponsors and collaborators

Lead sponsor

Agenzia Regionale Sanitaria delle Marche

Other Gov

Collaborators

Agenzia Nazionale per i Servizi Sanitari Regionali
Forum della Solidarieta
IRCCS Besta
Reggio Calabria
Regione Friuli Venezia Giulia
Regione Molise
Regione Puglia
Regione Siciliana
Regione Umbria
University of Eastern Piedmont

Registry information

Official study title

Diffusion of Clinical Pathways for the Implementation of Effective and Appropriate Care

Important dates

Study start: 2005
Primary completion: 2007
Study completion: 2007
First posted: May 7, 2008
Registry last updated: May 7, 2008

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed