Please use this identifier to cite or link to this item:
Title: Harmonizing allergy care-integrated care pathways and multidisciplinary approaches
Authors: Daniels, Lydia
Barker, Sally
Chang, Yoon-Seok
Chikovani, Tinatin
DunnGalvin, Audrey
Gerdts, Jennifer D
Wijk, Roy Gerth Van
Gibbs, Trevor
V. Villarreal-Gonzalez, Rosalaura
Guzman-Avilan, Rosa I
Hanna, Heather
Hossny, Elham
Kolotilina, Anastasia
Martell, Jose Antonio Ortega
Pacharn, Punchama
Quezada, Cindy E de Lira
Sibanda, Elopy
Stukus, David
Tham, Elizabeth Huiwen 
Venter, Carina
Gonzalez-Diaz, Sandra N
Levin, Michael E
Martin, Bryan
Munblit, Daniel
Warner, John O
Keywords: Science & Technology
Life Sciences & Biomedicine
Integrated care pathways
Multidisciplinary team
Issue Date: 10-Nov-2021
Publisher: ELSEVIER
Citation: Daniels, Lydia, Barker, Sally, Chang, Yoon-Seok, Chikovani, Tinatin, DunnGalvin, Audrey, Gerdts, Jennifer D, Wijk, Roy Gerth Van, Gibbs, Trevor, V. Villarreal-Gonzalez, Rosalaura, Guzman-Avilan, Rosa I, Hanna, Heather, Hossny, Elham, Kolotilina, Anastasia, Martell, Jose Antonio Ortega, Pacharn, Punchama, Quezada, Cindy E de Lira, Sibanda, Elopy, Stukus, David, Tham, Elizabeth Huiwen, Venter, Carina, Gonzalez-Diaz, Sandra N, Levin, Michael E, Martin, Bryan, Munblit, Daniel, Warner, John O (2021-11-10). Harmonizing allergy care-integrated care pathways and multidisciplinary approaches. WORLD ALLERGY ORGANIZATION JOURNAL 14 (10). ScholarBank@NUS Repository.
Abstract: There is a wide time gap between the publication of evidence and the application of new knowledge into routine clinical practice. The consequence is sub-optimal outcomes, particularly concerning for long-term relapsing/remitting conditions such as allergic diseases. In response, there has been a proliferation of published guidelines which systematically review evidence for the gold-standard management of most allergic disorders. However, this has not necessarily been followed by improved outcomes, partly due to a lack of coordination across the patient pathway. This has become known as the "second translational gap". A proposed solution is the development and implementation of integrated care pathways (ICPs) to optimize patient outcomes, with the notion that evidence-based medicine requires evidence-based implementation. ICP implementation is shown to improve short-term outcomes for acute conditions and routine surgery, including reduced length of hospital stay, improved documentation and improved patient safety. However, this improvement is not reflected in patient experience or patient-centered functional outcomes. The implementation of life-long, cost-effective interventions within comprehensive pathways requires a deep appreciation for complexity within allergy care. We promote an evidence-based methodology for the implementation of ICPs for allergic disorders in which all stakeholders in allergy care are positioned equally and encouraged to contribute, particularly patients and their caregivers. This evidence-based process commences with scoping the unmet needs, followed by stakeholder mapping. All stakeholders are invited to meetings to develop a common vision and mission through the generation of action/effect diagrams which helps build concordance across the agencies. Dividing the interventions into achievable steps and reviewing with plan/do/study/act cycles will gradually modify the pathway to achieve the best outcomes. While the management guidelines provide the core knowledge, the key component of implementation involves education, training, and support of all healthcare professionals (HCPs), patients and their caregivers. The pathways should define the level of competence required for each clinical task. It may be useful to leave the setting of care delivery or the specific HCP involved undefined to account for variable patterns of health service delivery as well as local socioeconomic, ethnic, environmental, and political imperatives. In all cases, where competence is exceeded, it is necessary to refer to the next stage in the pathway. The success and sustainability of ICPs would ideally be judged by patient experience, health outcomes, and health economics. We provide examples of successful programs, most notably from Finland, but recommend that further research is required in diverse settings to optimize outcomes worldwide.
ISSN: 19394551
DOI: 10.1016/j.waojou.2021.100584
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
Harmonizing allergy care-integrated care pathways and multidisciplinary approaches.pdf2.18 MBAdobe PDF



Google ScholarTM



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.