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European Quality of Care Pathways Study on the Effect of Care Pathways on Interprofessional Teamwork (EQCP-TEAM) (EQCP-TEAM)

Primary Purpose

Chronic Obstructive Pulmonary Disease, Proximal Femur Fracture

Status
Completed
Phase
Not Applicable
Locations
Belgium
Study Type
Interventional
Intervention
Care pathway.
Sponsored by
Dr. Kris Vanhaecht
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional health services research trial for Chronic Obstructive Pulmonary Disease focused on measuring interprofessional teamwork, care pathways, team communication, team coordination, Chronic Obstructive Pulmonary Disease Teams, Proximal Femur Fracture Teams

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Inclusion on cluster level requires the written agreement to participate form the hospital management, the medical head of the division and the head nurse
  • Next to this, they have to agree that they will not develop and implement a care pathway for COPD- exacerbation of PFF within the time frame of the study when randomized in the control group
  • Finally, the participating hospitals need an expected volume of more than one hundred COPD-exacerbation or PFF patients annually.
  • To have a comparable sample across all clusters, the following inclusion criteria on individual level are set:

    1. All professionals that according to the medical head of the division and head nurse are member of the interprofessional team caring for COPD-exacerbation or PFF patients from admission until discharge out of the acute hospital ward
    2. To be part of the interprofessional care team is further conceptualized as being part of the group of clinicians and staff who have a shared clinical purpose and direct care responsibilities for the respective patient group during the set time period
    3. All individual participants need to be member of the team during one specific week, where patients are being followed for the two other trials of the EQCP-project (8). This specific week is chosen by the study coordinator and can be defined as an average week, with normal staff ratios
    4. Because we want to study interprofessional teamwork, each cluster is asked to minimally include the orthopedic surgeons/pneumologists, head nurse, nurses, physiotherapists and social workers in their sample. Based on their own judgment, the chief medical doctor, in consensus with the head nurse, can decide to include other professional groups in their sample
    5. In some hospitals COPD-exacerbation or PFF patients are being admitted at multiple nursing wards, e.g. due to capacity problems or other organizational issues. If that is the case, then the clusters are asked to only include these team members that are working on the ward where the respective patient groups are being admitted most frequently.

Exclusion Criteria:

  • All team members that are not working (e.g. on leave) during the chosen week
  • All team members who are only temporarily part of the team (e.g. student nurses in training).

Sites / Locations

  • Katholieke Universiteit Leuven

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Care pathway teams.

Usual care teams.

Arm Description

In this experimental arm, the interprofessional teams will develop and implement a care pathways.

In the no intervention arm, the interprofessional teams will deliver usual care without implementing the intervention.

Outcomes

Primary Outcome Measures

Relational Coordination
Relational coordination describes the quality of communication and functional relations within a interprofessional team with shared goals and interdependent tasks.

Secondary Outcome Measures

Perceived Organisation of Care
The perceived organisation of care is a team indicator to measure the actual organisation of the care process. It is measured in a valid and reliable way by using the Care Process Self Evaluation Tool (CPSET).
Work engagement
Work engagement is a measure to analyse the level of competence, emotional exhaustion and mental detachement measured with the Burnout Inventory.
Team Climate
Team climate is an indicator to measure the team vision, participative safety, support for innovation and task orientation.

Full Information

First Posted
September 15, 2011
Last Updated
October 12, 2017
Sponsor
Dr. Kris Vanhaecht
Collaborators
KU Leuven, University of Eastern Piedmont
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1. Study Identification

Unique Protocol Identification Number
NCT01435538
Brief Title
European Quality of Care Pathways Study on the Effect of Care Pathways on Interprofessional Teamwork (EQCP-TEAM)
Acronym
EQCP-TEAM
Official Title
The Impact of Care Pathways on Interprofessional Teamwork: an International Cluster Randomized Controlled Trial
Study Type
Interventional

2. Study Status

Record Verification Date
October 2017
Overall Recruitment Status
Completed
Study Start Date
May 2009 (undefined)
Primary Completion Date
June 2014 (Actual)
Study Completion Date
January 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Dr. Kris Vanhaecht
Collaborators
KU Leuven, University of Eastern Piedmont

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Care pathways are complex interventions to support the interprofessional team in the redesign of their care process. This international cluster randomised trial will analyse the impact of the development and implementation of care pathways on the interprofessional teamwork.
Detailed Description
Background Although care pathways are often said to promote teamwork, high-level evidence that supports this statement is lacking. The objective of the European Quality of Care Pathway (EQCP) study is therefore to study the impact of care pathways on interprofessional teamwork. Methods/design An international post-test-only cluster Randomized Controlled Trial (cRCT), combined with process evaluations, will be performed in Belgium, Ireland, Italy and Portugal. Teams caring for Proximale Femur Fracture (PFF) patients and patients hospitalized with an exacerbation of Chronic Obstructive Pulmonary Disease (COPD) will be randomized 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 pathway-development. The control group will provide usual care. As effect measures a set of team input, process and output indicators will be used. Main outcome indicator is the team process indicator relational coordination. Next to these, process measures will be used to evaluate the implementation process. In total, 132 teams 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 The EQCP-study on teamwork is the first cluster-randomized controlled trial on the impact of care pathways on interprofessional teamwork. Results from our study will enhance understanding on the active components of care pathways. Through this, preferred implementation strategies can be defined.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Obstructive Pulmonary Disease, Proximal Femur Fracture
Keywords
interprofessional teamwork, care pathways, team communication, team coordination, Chronic Obstructive Pulmonary Disease Teams, Proximal Femur Fracture Teams

7. Study Design

Primary Purpose
Health Services Research
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
984 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Care pathway teams.
Arm Type
Experimental
Arm Description
In this experimental arm, the interprofessional teams will develop and implement a care pathways.
Arm Title
Usual care teams.
Arm Type
No Intervention
Arm Description
In the no intervention arm, the interprofessional teams will deliver usual care without implementing the intervention.
Intervention Type
Behavioral
Intervention Name(s)
Care pathway.
Intervention Description
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 pathway-development.
Primary Outcome Measure Information:
Title
Relational Coordination
Description
Relational coordination describes the quality of communication and functional relations within a interprofessional team with shared goals and interdependent tasks.
Time Frame
For average period of 3 months
Secondary Outcome Measure Information:
Title
Perceived Organisation of Care
Description
The perceived organisation of care is a team indicator to measure the actual organisation of the care process. It is measured in a valid and reliable way by using the Care Process Self Evaluation Tool (CPSET).
Time Frame
For average period of 3 months
Title
Work engagement
Description
Work engagement is a measure to analyse the level of competence, emotional exhaustion and mental detachement measured with the Burnout Inventory.
Time Frame
For average period of 3 months
Title
Team Climate
Description
Team climate is an indicator to measure the team vision, participative safety, support for innovation and task orientation.
Time Frame
For average period of 3 months

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Inclusion on cluster level requires the written agreement to participate form the hospital management, the medical head of the division and the head nurse Next to this, they have to agree that they will not develop and implement a care pathway for COPD- exacerbation of PFF within the time frame of the study when randomized in the control group Finally, the participating hospitals need an expected volume of more than one hundred COPD-exacerbation or PFF patients annually. To have a comparable sample across all clusters, the following inclusion criteria on individual level are set: All professionals that according to the medical head of the division and head nurse are member of the interprofessional team caring for COPD-exacerbation or PFF patients from admission until discharge out of the acute hospital ward To be part of the interprofessional care team is further conceptualized as being part of the group of clinicians and staff who have a shared clinical purpose and direct care responsibilities for the respective patient group during the set time period All individual participants need to be member of the team during one specific week, where patients are being followed for the two other trials of the EQCP-project (8). This specific week is chosen by the study coordinator and can be defined as an average week, with normal staff ratios Because we want to study interprofessional teamwork, each cluster is asked to minimally include the orthopedic surgeons/pneumologists, head nurse, nurses, physiotherapists and social workers in their sample. Based on their own judgment, the chief medical doctor, in consensus with the head nurse, can decide to include other professional groups in their sample In some hospitals COPD-exacerbation or PFF patients are being admitted at multiple nursing wards, e.g. due to capacity problems or other organizational issues. If that is the case, then the clusters are asked to only include these team members that are working on the ward where the respective patient groups are being admitted most frequently. Exclusion Criteria: All team members that are not working (e.g. on leave) during the chosen week All team members who are only temporarily part of the team (e.g. student nurses in training).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kris Vanhaecht, PhD
Organizational Affiliation
KU Leuven
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Walter Sermeus, PhD
Organizational Affiliation
KU Leuven
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Massimiliano Panella, PhD
Organizational Affiliation
Amedeo Avogadro University of Eastern Piemont
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Svin Deneckere, MSc
Organizational Affiliation
KU Leuven
Official's Role
Principal Investigator
Facility Information:
Facility Name
Katholieke Universiteit Leuven
City
Leuven
ZIP/Postal Code
3000
Country
Belgium

12. IPD Sharing Statement

Citations:
PubMed Identifier
21190951
Citation
Deneckere S, Robyns N, Vanhaecht K, Euwema M, Panella M, Lodewijckx C, Leigheb F, Sermeus W; EQCP-studygroup. Indicators for follow-up of multidisciplinary teamwork in care processes: results of an international expert panel. Eval Health Prof. 2011 Sep;34(3):258-77. doi: 10.1177/0163278710393736. Epub 2010 Dec 29.
Results Reference
background
PubMed Identifier
34766330
Citation
Handoll HH, Cameron ID, Mak JC, Panagoda CE, Finnegan TP. Multidisciplinary rehabilitation for older people with hip fractures. Cochrane Database Syst Rev. 2021 Nov 12;11(11):CD007125. doi: 10.1002/14651858.CD007125.pub3.
Results Reference
derived
PubMed Identifier
22607698
Citation
Deneckere S, Euwema M, Lodewijckx C, Panella M, Sermeus W, Vanhaecht K. 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. Implement Sci. 2012 May 18;7:47. doi: 10.1186/1748-5908-7-47.
Results Reference
derived
Links:
URL
http://www.E-P-A.org
Description
European Pathway Association

Learn more about this trial

European Quality of Care Pathways Study on the Effect of Care Pathways on Interprofessional Teamwork (EQCP-TEAM)

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