Implementation of consensus-based perioperative care pathways to reduce clinical variation for elective surgery in an Australian private hospital: a mixed-methods pre–post study protocol
Introduction Addressing clinical variation in elective surgery is challenging. A key issue is how to gain consensus between largely autonomous clinicians. Understanding how the consensus process works to develop and implement perioperative pathways and the impact of these pathways on reducing clinic...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/7/e075008.full |
| _version_ | 1797745896033615872 |
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| author | Jeffrey Braithwaite Peter D Hibbert Kate Churruca Louise A Ellis Janet C Long Gaston Arnolda Mitchell N Sarkies Emilie Francis-Auton Andrew Partington Karen Hutchinson David Gillatt Luke Testa Lisa Pagano Cameron Hemmert Andrew Hirschhorn Graham Gumley Cliff Hughes Romika Patel |
| author_facet | Jeffrey Braithwaite Peter D Hibbert Kate Churruca Louise A Ellis Janet C Long Gaston Arnolda Mitchell N Sarkies Emilie Francis-Auton Andrew Partington Karen Hutchinson David Gillatt Luke Testa Lisa Pagano Cameron Hemmert Andrew Hirschhorn Graham Gumley Cliff Hughes Romika Patel |
| author_sort | Jeffrey Braithwaite |
| collection | DOAJ |
| description | Introduction Addressing clinical variation in elective surgery is challenging. A key issue is how to gain consensus between largely autonomous clinicians. Understanding how the consensus process works to develop and implement perioperative pathways and the impact of these pathways on reducing clinical variation can provide important insights into the effectiveness of the consensus process. The primary objective of this study is to understand the implementation of an organisationally supported, consensus approach to implement perioperative care pathways in a private healthcare facility and to determine its impact.Methods A mixed-methods Effectiveness-Implementation Hybrid (type III) pre–post study will be conducted in one Australian private hospital. Five new consensus-based perioperative care pathways will be developed and implemented for specific patient cohorts: spinal surgery, radical prostatectomy, cardiac surgery, bariatric surgery and total hip and knee replacement. The individual components of these pathways will be confirmed as part of a consensus-building approach and will follow a four-stage implementation process using the Exploration, Preparation, Implementation and Sustainment framework. The process of implementation, as well as barriers and facilitators, will be evaluated through semistructured interviews and focus groups with key clinical and non-clinical staff, and participant observation. We anticipate completing 30 interviews and 15–20 meeting observations. Administrative and clinical end-points for at least 152 participants will be analysed to assess the effectiveness of the pathways.Ethics and dissemination This study received ethical approval from Macquarie University Human Research Ethics Medical Sciences Committee (Reference No: 520221219542374). The findings of this study will be disseminated through peer-reviewed publications, conference presentations and reports for key stakeholders. |
| first_indexed | 2024-03-12T15:29:32Z |
| format | Article |
| id | doaj.art-65e4ec841d0f403595eacb45f3470b64 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-12T15:29:32Z |
| publishDate | 2023-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-65e4ec841d0f403595eacb45f3470b642023-08-10T08:45:07ZengBMJ Publishing GroupBMJ Open2044-60552023-07-0113710.1136/bmjopen-2023-075008Implementation of consensus-based perioperative care pathways to reduce clinical variation for elective surgery in an Australian private hospital: a mixed-methods pre–post study protocolJeffrey Braithwaite0Peter D Hibbert1Kate Churruca2Louise A Ellis3Janet C Long4Gaston Arnolda5Mitchell N Sarkies6Emilie Francis-Auton7Andrew Partington8Karen Hutchinson9David Gillatt10Luke Testa11Lisa Pagano12Cameron Hemmert13Andrew Hirschhorn14Graham Gumley15Cliff Hughes16Romika Patel17Australian Institute of Health Innovation, Macquarie University, Sydney, AustraliaAustralian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaAustralian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaAustralian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaAustralian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, AustraliaAustralian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaSchool of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, AustraliaAustralian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, AustraliaAustralian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaAustralian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaMQ Health, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaAustralian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaAustralian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaSchool of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, AustraliaMQ Health, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaMQ Health, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaAustralian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaAustralian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaIntroduction Addressing clinical variation in elective surgery is challenging. A key issue is how to gain consensus between largely autonomous clinicians. Understanding how the consensus process works to develop and implement perioperative pathways and the impact of these pathways on reducing clinical variation can provide important insights into the effectiveness of the consensus process. The primary objective of this study is to understand the implementation of an organisationally supported, consensus approach to implement perioperative care pathways in a private healthcare facility and to determine its impact.Methods A mixed-methods Effectiveness-Implementation Hybrid (type III) pre–post study will be conducted in one Australian private hospital. Five new consensus-based perioperative care pathways will be developed and implemented for specific patient cohorts: spinal surgery, radical prostatectomy, cardiac surgery, bariatric surgery and total hip and knee replacement. The individual components of these pathways will be confirmed as part of a consensus-building approach and will follow a four-stage implementation process using the Exploration, Preparation, Implementation and Sustainment framework. The process of implementation, as well as barriers and facilitators, will be evaluated through semistructured interviews and focus groups with key clinical and non-clinical staff, and participant observation. We anticipate completing 30 interviews and 15–20 meeting observations. Administrative and clinical end-points for at least 152 participants will be analysed to assess the effectiveness of the pathways.Ethics and dissemination This study received ethical approval from Macquarie University Human Research Ethics Medical Sciences Committee (Reference No: 520221219542374). The findings of this study will be disseminated through peer-reviewed publications, conference presentations and reports for key stakeholders.https://bmjopen.bmj.com/content/13/7/e075008.full |
| spellingShingle | Jeffrey Braithwaite Peter D Hibbert Kate Churruca Louise A Ellis Janet C Long Gaston Arnolda Mitchell N Sarkies Emilie Francis-Auton Andrew Partington Karen Hutchinson David Gillatt Luke Testa Lisa Pagano Cameron Hemmert Andrew Hirschhorn Graham Gumley Cliff Hughes Romika Patel Implementation of consensus-based perioperative care pathways to reduce clinical variation for elective surgery in an Australian private hospital: a mixed-methods pre–post study protocol BMJ Open |
| title | Implementation of consensus-based perioperative care pathways to reduce clinical variation for elective surgery in an Australian private hospital: a mixed-methods pre–post study protocol |
| title_full | Implementation of consensus-based perioperative care pathways to reduce clinical variation for elective surgery in an Australian private hospital: a mixed-methods pre–post study protocol |
| title_fullStr | Implementation of consensus-based perioperative care pathways to reduce clinical variation for elective surgery in an Australian private hospital: a mixed-methods pre–post study protocol |
| title_full_unstemmed | Implementation of consensus-based perioperative care pathways to reduce clinical variation for elective surgery in an Australian private hospital: a mixed-methods pre–post study protocol |
| title_short | Implementation of consensus-based perioperative care pathways to reduce clinical variation for elective surgery in an Australian private hospital: a mixed-methods pre–post study protocol |
| title_sort | implementation of consensus based perioperative care pathways to reduce clinical variation for elective surgery in an australian private hospital a mixed methods pre post study protocol |
| url | https://bmjopen.bmj.com/content/13/7/e075008.full |
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