Literature DB >> 23999833

Evaluation of the impact of a clinical pathway on the organization of a multidisciplinary dental sleep clinic.

D M Ten Berge1, M J Braem, A Altenburg, M Dieltjens, P H Van de Heyning, K Vanhaecht, O M Vanderveken.   

Abstract

PURPOSE: Clinical pathways are used to organize complex care processes by providing structure and standardization. The multidisciplinary approach of oral appliance (OA) therapy for sleep-disordered breathing (SDB) is a complex and dynamic process suitable for such a structured pathway approach.
METHODS: A clinical pathway for patients referred for OA therapy was developed and implemented. The aim of this study was to evaluate the impact of this clinical pathway on the time to delivery of the OA and the organization of the multidisciplinary dental sleep clinic (MDSC). The latter was achieved using the care process self-evaluation tool (CPSET).
RESULTS: First, development and implementation of the clinical pathway gave structure and shortened the mean time to delivery by 102 days (240 ± 70 vs. 138 ± 33 days) (Mann-Whitney U: P < 0.001). Second, the CPSET scores were obtained in a cohort of 49 healthcare professionals involved in the pathway. Overall, patient-focused organization received the highest scores (80.5 ± 9.0%), whereas cooperation with primary care received the lowest score (66.7 ± 12.4%).
CONCLUSIONS: This is the first project on clinical pathways in OA therapy for SDB. The implementation of the pathway in our MDSC has created a significant shortening of the time to delivery. A first evaluation of the clinical pathway using the CPSET scores indicates that all disciplines involved should be thoroughly informed in an ongoing approach.

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Year:  2013        PMID: 23999833     DOI: 10.1007/s11325-013-0888-2

Source DB:  PubMed          Journal:  Sleep Breath        ISSN: 1520-9512            Impact factor:   2.816


  41 in total

1.  A method of studying adaptive changes of the oropharynx to variation in mandibular position in patients with obstructive sleep apnoea.

Authors:  P R L'Estrange; J M Battagel; B Harkness; M H Spratley; P J Nolan; G I Jorgensen
Journal:  J Oral Rehabil       Date:  1996-10       Impact factor: 3.837

2.  Have we drawn the wrong conclusions about the value of care pathways? Is a Cochrane review appropriate?

Authors:  Kris Vanhaecht; John Ovretveit; Martin J Elliott; Walter Sermeus; John Ellershaw; Massimiliano Panella
Journal:  Eval Health Prof       Date:  2011-06-27       Impact factor: 2.651

3.  Position paper by Canadian dental sleep medicine professionals on the role of different health care professionals in managing obstructive sleep apnea and snoring with oral appliances.

Authors:  Luc Gauthier; Fernanda Almeida; Jean-Patrick Arcache; Catherine Ashton-McGregor; David Coté; Helen S Driver; Kathleen A Ferguson; Gilles J Lavigne; Philippe Martin; Jean-François Masse; Florence Morisson; Jeffrey Pancer; Charles Harry Samuels; Maurice Schachter; Frédéric Sériès; Glendon Edward Sullivan
Journal:  Can Respir J       Date:  2012 Sep-Oct       Impact factor: 2.409

Review 4.  Cardiovascular implications in the treatment of obstructive sleep apnea.

Authors:  Olivier M Vanderveken; An Boudewyns; Quan Ni; Bhavani Kashyap; Johan Verbraecken; Wilfried De Backer; Paul Van de Heyning
Journal:  J Cardiovasc Transl Res       Date:  2010-11-20       Impact factor: 4.132

Review 5.  Treatment of snoring and obstructive sleep apnea with mandibular repositioning appliances.

Authors:  Peter A Cistulli; Helen Gotsopoulos; Marie Marklund; Alan A Lowe
Journal:  Sleep Med Rev       Date:  2004-12       Impact factor: 11.609

6.  The occurrence of sleep-disordered breathing among middle-aged adults.

Authors:  T Young; M Palta; J Dempsey; J Skatrud; S Weber; S Badr
Journal:  N Engl J Med       Date:  1993-04-29       Impact factor: 91.245

Review 7.  Oral appliances for snoring and obstructive sleep apnea: a review.

Authors:  Kathleen A Ferguson; Rosalind Cartwright; Robert Rogers; Wolfgang Schmidt-Nowara
Journal:  Sleep       Date:  2006-02       Impact factor: 5.849

8.  Titrated mandibular advancement versus positive airway pressure for sleep apnoea.

Authors:  F Gagnadoux; B Fleury; B Vielle; B Pételle; N Meslier; X L N'Guyen; W Trzepizur; J L Racineux
Journal:  Eur Respir J       Date:  2009-03-26       Impact factor: 16.671

9.  Development and validation of a care process self-evaluation tool.

Authors:  Kris Vanhaecht; Karel De Witte; Roeland Depreitere; Ruben Van Zelm; Leentje De Bleser; Karin Proost; Walter Sermeus
Journal:  Health Serv Manage Res       Date:  2007-08

Review 10.  Review of oral appliances for treatment of sleep-disordered breathing.

Authors:  Victor Hoffstein
Journal:  Sleep Breath       Date:  2007-03       Impact factor: 2.816

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  1 in total

1.  A promising concept of combination therapy for positional obstructive sleep apnea.

Authors:  Marijke Dieltjens; Anneclaire V Vroegop; Annelies E Verbruggen; Kristien Wouters; Marc Willemen; Wilfried A De Backer; Johan A Verbraecken; Paul H Van de Heyning; Marc J Braem; Nico de Vries; Olivier M Vanderveken
Journal:  Sleep Breath       Date:  2014-10-22       Impact factor: 2.816

  1 in total

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