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Improving Customisation in Clinical Pathways by Using a Modular Perspective

A standardised system of clinical pathways often conflicts with providing patient-centred heterogeneous care. Mental health care organisations are searching for new methods to become responsive towards unique treatment needs. Modularity is a method increasingly suggested to reconcile standardisation...

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Detalles Bibliográficos
Autores principales: van Dam, Anne, Metz, Margot, Meijboom, Bert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8583020/
https://www.ncbi.nlm.nih.gov/pubmed/34769647
http://dx.doi.org/10.3390/ijerph182111129
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author van Dam, Anne
Metz, Margot
Meijboom, Bert
author_facet van Dam, Anne
Metz, Margot
Meijboom, Bert
author_sort van Dam, Anne
collection PubMed
description A standardised system of clinical pathways often conflicts with providing patient-centred heterogeneous care. Mental health care organisations are searching for new methods to become responsive towards unique treatment needs. Modularity is a method increasingly suggested to reconcile standardisation and customisation. The aim is to investigate the extent to which modularity can be applied to make clinical pathways in specialist mental health care more flexible in order to stimulate shared decision making (SDM) and thereby customise care processes to patient contexts while maintaining evidence-based standards. Methods consist of literature research and a theory-based case study including document analysis and semi-structured interviews, which were performed at a Dutch specialist mental health care organisation. The results show that in current literature two modularity-based structures are proposed that support flexibility and customisation, i.e., ‘Prototype’ and ‘Menu-based’. This study reveals that departments tend to use the prototype method if they have predictable patient needs, evidence-based methods are available and there is sequency in treatment components. The menu-based method is preferred if there are unpredictable needs, or the evidence needed to create interconnectedness in treatment is lacking. In conclusion, prototype or menu-based methods are both suitable for applying SDM and reaching customisation in practice. The choice is determined by three characteristics: predictability of needs, availability of evidence and the interconnectedness of treatment components.
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spelling pubmed-85830202021-11-12 Improving Customisation in Clinical Pathways by Using a Modular Perspective van Dam, Anne Metz, Margot Meijboom, Bert Int J Environ Res Public Health Article A standardised system of clinical pathways often conflicts with providing patient-centred heterogeneous care. Mental health care organisations are searching for new methods to become responsive towards unique treatment needs. Modularity is a method increasingly suggested to reconcile standardisation and customisation. The aim is to investigate the extent to which modularity can be applied to make clinical pathways in specialist mental health care more flexible in order to stimulate shared decision making (SDM) and thereby customise care processes to patient contexts while maintaining evidence-based standards. Methods consist of literature research and a theory-based case study including document analysis and semi-structured interviews, which were performed at a Dutch specialist mental health care organisation. The results show that in current literature two modularity-based structures are proposed that support flexibility and customisation, i.e., ‘Prototype’ and ‘Menu-based’. This study reveals that departments tend to use the prototype method if they have predictable patient needs, evidence-based methods are available and there is sequency in treatment components. The menu-based method is preferred if there are unpredictable needs, or the evidence needed to create interconnectedness in treatment is lacking. In conclusion, prototype or menu-based methods are both suitable for applying SDM and reaching customisation in practice. The choice is determined by three characteristics: predictability of needs, availability of evidence and the interconnectedness of treatment components. MDPI 2021-10-22 /pmc/articles/PMC8583020/ /pubmed/34769647 http://dx.doi.org/10.3390/ijerph182111129 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
van Dam, Anne
Metz, Margot
Meijboom, Bert
Improving Customisation in Clinical Pathways by Using a Modular Perspective
title Improving Customisation in Clinical Pathways by Using a Modular Perspective
title_full Improving Customisation in Clinical Pathways by Using a Modular Perspective
title_fullStr Improving Customisation in Clinical Pathways by Using a Modular Perspective
title_full_unstemmed Improving Customisation in Clinical Pathways by Using a Modular Perspective
title_short Improving Customisation in Clinical Pathways by Using a Modular Perspective
title_sort improving customisation in clinical pathways by using a modular perspective
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8583020/
https://www.ncbi.nlm.nih.gov/pubmed/34769647
http://dx.doi.org/10.3390/ijerph182111129
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