title: Evaluation of the impact of a clinical pathway on the organization of a multidisciplinary dental sleep clinic.
abstract: OBJECTIVE
  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.
authors.affiliation: Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
authors.forename: D M
authors.initials: DM
authors.lastname: Ten Berge
authors.forename: M J
authors.initials: MJ
authors.lastname: Braem
authors.forename: A
authors.initials: A
authors.lastname: Altenburg
authors.forename: M
authors.initials: M
authors.lastname: Dieltjens
authors.forename: P H
authors.initials: PH
authors.lastname: Van de Heyning
authors.forename: K
authors.initials: K
authors.lastname: Vanhaecht
authors.forename: O M
authors.initials: OM
authors.lastname: Vanderveken
mesh_terms: D000328:Adult; D000368:Aged; D001530:Belgium; D003299:Cooperative Behavior; D019091:Critical Pathways / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration; D003740:Dental Clinics / Q000458:organization & administration*; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation*; D008875:Middle Aged; D009967:Orthodontic Appliances; D010348:Patient Care Team / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult