Deneckere Svin, Euwema Martin, Van Herck Pieter, Lodewijckx Cathy, Panella Massimiliano, Sermeus Walter, Vanhaecht Kris
Public Health School, Faculty of Medicine, KU Leuven, Belgium.
Soc Sci Med. 2012 Jul;75(2):264-8. doi: 10.1016/j.socscimed.2012.02.060. Epub 2012 Apr 20.
Care pathways are often said to promote interprofessional teamwork. As no systematic review on pathway effectiveness has ever focused on how care pathways promote teamwork, the objective of this review was to study this relationship. We performed an extensive search of electronic databases and identified 26 relevant studies. In our analysis of these studies we identified 20 team indicators and found that care pathways positively affected 17 of these indicators. Most frequently positive effects were found on staff knowledge, interprofessional documentation, team communication and team relations. However, the level of evidence was rather low. We found Level II evidence for improved interprofessional documentation. We also found Level II evidence for increased workload; improved actual versus planned team size; and improved continuity of care. The studies most frequently mentioned the need for a multidisciplinary approach and educational training sessions in order for pathways to be successful. The systematic review revealed that care pathways have the potential to support interprofessional teams in enhancing teamwork. Necessary conditions are a context that supports teamwork and including appropriate active pathway components that can mediate an effect on team processes. To achieve this, each care pathway requires a clearly defined team approach customized to the individual teams' needs.
护理路径常被认为有助于促进跨专业团队合作。由于此前尚无关于路径有效性的系统评价关注护理路径如何促进团队合作，本评价的目的是研究这种关系。我们对电子数据库进行了广泛检索，确定了26项相关研究。在对这些研究的分析中，我们确定了20个团队指标，发现护理路径对其中17个指标有积极影响。最常发现积极影响的方面是员工知识、跨专业文档记录、团队沟通和团队关系。然而，证据水平相当低。我们发现有二级证据表明跨专业文档记录有所改善。我们还发现有二级证据表明工作量增加；实际团队规模与计划团队规模相比有所改善；护理连续性得到改善。这些研究最常提到，为使路径取得成功，需要采取多学科方法并开展教育培训课程。该系统评价表明，护理路径有潜力支持跨专业团队加强团队合作。必要条件是有支持团队合作的环境，以及纳入能够对团队流程产生影响的适当积极路径组成部分。要实现这一点，每条护理路径都需要根据各个团队的需求定制明确界定的团队方法。
