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Publication :
Clinical pathway efficiency for elective joint replacement surgeries : a case study

bul.description.provenancenoadg chlacfr
bul.rights.dateAccepPubl2019-05-24fr
bul.rights.periodeEmbargoforeverfr
bul.rights.raisonEmbargoInfiniPour que le document soit diffusé en libre accès, en accord avec le délai prescrit par l’éditeur, il faudrait déposer la version acceptée pour publication, incluant toutes les modifications demandées, mais sans la mise en page de la revue. Pour ce faire, effectuez une demande de modification à l’aide de la liste des dépôts diffusés à partir du tableau de suivi.fr
bul.rights.typeDatedatePublicationfr
dc.contributor.authorCôté, André
dc.contributor.authorLaberge, Maude
dc.contributor.authorRuiz, Angel
dc.coverage.spatialCanadafr
dc.date.accessioned2022-01-07T02:10:41Z
dc.date.available9999-12-31
dc.date.issued2019-05-24
dc.description.abstractPurpose – The purpose of this paper is to define a clinical pathway for total joint replacement (TJR) surgery, estimate the effect of delays between steps of the pathway on wait time for surgery and to identify factors contributing to more efficient operations and challenges to their implementation. Design/methodology/approach – This is a case study with a mixed methods approach. The authors conducted interviews with hospital staff. Data collected in the interviews and through on-site observation were analyzed to map the TJR process and identify the steps of the care pathway. The authors extracted and analyzed data (time stamps) from 60 hospital patient records for each step in the pathway and ran a regression on the duration of the whole trajectory. Findings – There were wide variations in the delays observed between the seven steps identified. The delay between Step 1 and Step 2 was the only significant variable in predicting the total wait time to surgery. In one hospital, one delay explained 50 percent of the variation. There was misalignment between findings from the qualitative data in terms of strategies implemented to increase efficiency of the clinical pathway to the quantitative data on delays between the steps. Research limitations/implications – The study identified the clinical pathway from the consultation with an orthopaedic surgeon to the surgery. However, it did not go beyond the surgery. Future research could investigate the relationship between specific processes and delays between steps of the process and patient outcomes, including length of stay, mobilization and functionality in activities of daily living, as well as potential complications from surgery, readmission and the services required after the patient was discharged. Practical implications – Wait times can be addressed by implementing strategies at the health system level or at the organizational level. The authors found and discuss areas where there could be efficiency gains for health care organizations. Social implications – Stakeholders in care processes are diverse and they each have their preferences in how they practice (in the case of providers) and how they perceive and wish to respond adequately to patients’ needs in contexts that have different norms and approaches. The approach in this study enables a better understanding of the processes, the organizational culture and how these may affect each other. Originality/value – Our mixed methods enabled a process mapping and the identification of factors that significantly affected the efficiency of the TJR surgery process. It combines methods from process engineering with health services and management research. To some extent, this study demonstrates that although managers can define and enforce processes, organizational culture and practices are harder to influence.fr
dc.identifier.doi10.1108/JHOM-03-2018-0087fr
dc.identifier.issn1477-7266fr
dc.identifier.urihttp://hdl.handle.net/20.500.11794/71366
dc.languageengfr
dc.publisherEmerald/MCB University Pressfr
dc.rightshttp://purl.org/coar/access_right/c_16ec
dc.subjectLean, Efficiencyfr
dc.subjectEfficiencyfr
dc.subjectElective surgeryfr
dc.subjectWaiting listsfr
dc.subject.rvmArthroplastie de la hanchefr
dc.subject.rvmArthroplastie du genoufr
dc.subject.rvmCheminements cliniquesfr
dc.subject.rvmHôpitaux -- Listes d'attentefr
dc.subject.rvmSoins hospitaliers -- Coût-efficacitéfr
dc.subject.rvmChirurgie électivefr
dc.titleClinical pathway efficiency for elective joint replacement surgeries : a case studyfr
dc.typearticle de recherche
dc.type.legacyCOAR1_1::Texte::Périodique::Revue::Contribution à un journal::Article::Article de recherchefr
dcterms.bibliographicCitationJournal of health organization and management, Vol. 33 (3), 323-338 (2019)fr
dspace.accessstatus.time2024-03-23 18:00:55
dspace.entity.typePublication
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rioxxterms.versionVersion of Record (VoR)fr
rioxxterms.version-of-recordhttps://doi.org/10.1108/JHOM-03-2018-0087fr

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