title: The European quality of care pathways (EQCP) study on the impact of care pathways on interprofessional teamwork in an acute hospital setting: study protocol: for a cluster randomised controlled trial and evaluation of implementation processes.
abstract: BACKGROUND
  Although care pathways are often said to promote teamwork, high-level evidence that supports this statement is lacking. Furthermore, knowledge on conditions and facilitators for successful pathway implementation is scarce. The objective of the European Quality of Care Pathway (EQCP) study is therefore to study the impact of care pathways on interprofessional teamwork and to build up understanding on the implementation process.
  
  
  METHODS
  An international post-test-only cluster Randomised Controlled Trial (cRCT), combined with process evaluations, will be performed in Belgium, Ireland, Italy, and Portugal. Teams caring for proximal femur fracture (PFF) patients and patients hospitalized with an exacerbation of chronic obstructive pulmonary disease (COPD) will be randomised into an intervention and control group. The intervention group will implement a care pathway for PFF or COPD containing three active components: a formative evaluation of the actual teams' performance, a set of evidence-based key interventions, and a training in care pathway-development. The control group will provide usual care. A set of team input, process and output indicators will be used as effect measures. The main outcome indicator will be relational coordination. Next to these, process measures during and after pathway development will be used to evaluate the implementation processes. In total, 132 teams have agreed to participate, of which 68 were randomly assigned to the intervention group and 64 to the control group. Based on power analysis, a sample of 475 team members per arm is required. To analyze results, multilevel analysis will be performed.
  
  
  CONCLUSIONS
  Results from our study will enhance understanding on the active components of care pathways. Through this, preferred implementation strategies can be defined.
authors.affiliation: Public Health School, Faculty of Medicine, KU Leuven, Kapucijnenvoer, Leuven, Belgium. svin.deneckere@med.kuleuven.be
authors.forename: Svin
authors.initials: S
authors.lastname: Deneckere
authors.forename: Martin
authors.initials: M
authors.lastname: Euwema
authors.forename: Cathy
authors.initials: C
authors.lastname: Lodewijckx
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Panella
authors.forename: Walter
authors.initials: W
authors.lastname: Sermeus
authors.forename: Kris
authors.initials: K
authors.lastname: Vanhaecht
mesh_terms: D015897:Comorbidity; D019091:Critical Pathways; D005060:Europe; D005264:Femoral Fractures / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D007400:Interprofessional Relations; D017064:Process Assessment, Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D012107:Research Design