Pathways in multidisciplinary oral health care as a tool to improve clinical performance.
OBJECTIVE
To investigate the optimization of multidisciplinary and interdisciplinary oral health care through the introduction of pathways.


METHODS
A prospective randomized clinical trial was carried out in a tertiary referral academic institution. Ninety-one patients admitted for multidisciplinary oral health care from January 1, 2001, to March 31, 2003, were randomized to the test group (n = 50) or to the control group (n = 41). Pathways were implemented by means of the Medical Patient Management program, a computerized planning and coordination system specifically developed for a population with multidisciplinary oral rehabilitation needs. The efficiency of pathways in interdisciplinary oral health care was assessed.


RESULTS
Statistically significant differences between test and control groups were found for variables regarding the process of care, such as "number of planned versus actual disciplines," "length of planned versus actual treatment," and "average length of a treatment session." For variables regarding patient satisfaction, significant differences between test and control groups were found for questions regarding patient involvement with the treatment and patient satisfaction with the outcome of multidisciplinary treatment. Regarding practitioner satisfaction, the results of the questionnaire indicate that implementation of pathways into everyday clinical practice is desired but remains difficult.


CONCLUSIONS
The findings of this study show that the implementation of pathways in multidisciplinary oral health care improved some aspects of the process of care and increased patient satisfaction. The predictive capability of the Medical Patient Management program in managing oral health care has been demonstrated.
Vandamme
Katleen
K
Department of Prosthetic Dentistry/BIOMAT Research Group, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Belgium.
Opdebeeck
Heidi
H
Naert
Ignace
I
D001291:Attitude of Health Personnel; D019091:Critical Pathways; D019033:Delivery of Health Care, Integrated; D003729:Dental Care / Q000592:standards; D017598:Efficiency, Organizational / Q000592:standards; D006801:Humans; D008331:Management Information Systems; D009065:Mouth Rehabilitation; D010348:Patient Care Team; D010358:Patient Participation; D017060:Patient Satisfaction; D017064:Process Assessment, Health Care; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome