How to optimize care pathways? Essential steps and key success factors for change management

Thinking about how to take care of patients in their care pathways is at the heart of the reflections of private and public players in the world of health, whatever the therapeutic area. In fact, the reflection process responds to major societal challenges such as improving the patient’s health and quality of life, the economic efficiency of care, and the fluidity of the city-hospital link.

Carrying out an optimization of care pathways: 3 challenges to be met

1. Identify a project leader

Identify a project leader, such as an opinion leader, capable of rallying around him/her on the importance of this issue in order to mobilize the forces of his/her local sector with the aim of change. In order to have a wider impact, this vision could be developed during scientific events organized by the hospital center, learned societies or private actors, but also through publications.

2. Build and align to a reference point for care pathways

Build and align to a reference point corresponding to the recommendations of the learned societies or to the image of the ideal situation defined locally by teams on the basis of what the teams dream of doing. This reference point can be used to establish a diagnosis of the initial situation. These inventories are triggering elements that highlight the need to improve the care pathway.

3. Communicate on the feasability of optimizing care pathways

Communicate that this is possible, based on concrete cases that have succeeded in optimizing a care pathway and reaching the chosen reference point. Successes are sources of inspiration and motivation.

How to define the necessary transformation for a treatment course?

Here are 2 essential steps and a key factor of success:

First step: identify the points of blockage

The first step is to identify the points of blockage in the course of care that prevent the expected objectives and the reference situation from being achieved. An analysis of the feedback from tracer patients, individual interviews with health professionals involved in patient care, or an understanding of local constraints are key to establishing a complete diagnosis and identifying these blockage points.

Second step: prioritize these points for improvement

A second step is the prioritization of these points for improvement. This is essential because making choices not only contributes to the commitment of the teams, but also limits the dispersion of resources and increases the chances of success. The involvement of a multidisciplinary committee in this stage, for example, bringing together the medical, nursing and administrative staff of a hospital center, makes it possible to align all the stakeholders around a common, co-constructed action plan.

A key success factor: build solutions for care pathways that remain simple and realistic

A key success factor is to build solutions that remain simple in their development and implementation, and realistic by taking into account local constraints. The examples of route optimization, which are fundamental in creating the initial impetus, also represent models of solutions to be replicated and adapted. This may involve creating an algorithm for identifying patients at risk in order to enable more specific follow-up or setting up a framework for systematizing the performance of an examination.

Once the solutions have been built, a final challenge of change management begins.

How to ensure that the solutions are implemented and monitored over time?

Here are 4 elements that can help :

1. Identify the driver of change in the field, the key to monitoring and supporting the implementation of solutions. Such a program is spread out over time, from 6 months to 1 year after the first exchanges. This person’s mission will be to maintain the commitment of the participants, in particular by recalling the co-constructed roadmap and making it evolve if necessary.
2. Evaluate the impact of the project by monitoring the evolution of indicators. These may include the number of patients involved in a system, the satisfaction of patients and/or healthcare professionals, the reduction in waiting times, or the number of patients followed up with in a service. This will make the change tangible and quantifiable and will make it possible to project changes over time.
3. Undertake a continuous improvement process in order, on the basis of an initial impact analysis, to identify new areas for improvement that will enable the process to be undertaken over time, to ensure that changes bring the expected results, are always adapted and, if necessary, are adjusted. The pilot will be in charge of bringing this approach to life.
4. Communicate on the optimization project in order to involve the stakeholders over the long term and to enhance the value of the work carried out. A publication or a communication at a scientific event can be a means of making this change a reality and disseminating good practices more widely.

Thus, optimizing care pathways is at the heart of the current and future challenges facing healthcare systems. Taking up the associated challenges by creating the initial impetus, developing simple and impactful solutions, and setting up concrete communication around the impact of change contribute to the success of these projects which are essentially multidisciplinary and where private or public players can work together in the service of patients. If these issues concern you, our team at Alcimed can accompany you in this adventure!

About the authors
Marie-Alix, Senior Consultant and Luc, Business Unit Director in Alcimed’s Healthcare team in France