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. 2012 May 18:7:47.
doi: 10.1186/1748-5908-7-47.

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

Svin Deneckere  1 , Martin Euwema, Cathy Lodewijckx, Massimiliano Panella, Walter Sermeus, Kris Vanhaecht
Affiliations

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

Svin Deneckere et al. Implement Sci. .

Abstract

Background: 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.

Methods/design: 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.

Discussion: Results from our study will enhance understanding on the active components of care pathways. Through this, preferred implementation strategies can be defined.

Trial registration: ClinicalTrials.gov NCT01435538.

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Figures

Figure 1
Figure 1
Study design of the EQCP-trial on teamwork.
Figure 2
Figure 2
Participating teams in the EQCP-trial on teamwork.
Figure 3
Figure 3
Active components of the EQCP-complex intervention.
Figure 4
Figure 4
Care pathway implementation protocol based on the Deming-PlanDoStudyAct cycle.
See this image and copyright information in PMC

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