Development of a Clinical Pathway for Patients with Chronic Rotator Cuff Tears

Clinical care pathways can be described as evidence-based best practice care that set out all of the decisions and services involved in treating a condition, are widely accepted, and are highly utilized. Clinical care pathways reduce unnecessary variations in patient care, improve quality of care, and reduce healthcare costs. Quality improvements in healthcare, however, cannot be achieved through the development of a clinical care pathway alone. In conjunction with the development of a clinical care pathway (i.e., the ideal pathway), the current pathway must be evaluated and compared to the ideal clinical care pathway in order to influence policy changes, identify and eliminate potential gaps in care, and to ensure equitable, seamless, and sustainable access to high-quality care for everyone. The purpose of this doctoral research, which comprises of a series of inter-related studies, was to execute the steps required to propose quality improvements in caring for patients presenting to the healthcare system with chronic rotator cuff tears. Specifically, the research questions examines what gaps in quality of care exist in the current system based on a comparison of the ideal and current standards of care for patients presenting to the healthcare system with chronic rotator cuff tears. Consequently, this thesis 1) reviewed the literature to provide context for chronic rotator cuff tears and to determine the need for a clinical care pathway; 2) proposed best practice care by establishing clinical consensus and patient flow algorithms for diagnosing and treating patients with rotator cuff pathology; 3) conducted further validity and reliability testing of two patient-reported outcome measures: the Rotator Cuff Quality-of-Life Index (RC-QOL) (Appendix A) and the Healthcare Access and Patient Satisfaction Questionnaire (HAPSQ) (Appendix B); 4) evaluated the current quality of care for patients with chronic rotator cuff tears using the RC-QOL and the HAPSQ; 5) compared current and ideal standards of care to identify gaps in the current healthcare system; and 6) explored the business case for best practice clinical care for patients in Alberta. Findings from this research demonstrated a need for healthcare reform for patients receiving care in the current system.

Name thesis:degree_name

Doctor of Philosophy (PhD)

Discipline thesis:degree_discipline

Kinesiology

Grantor dc:publisher.institution

Kinesiology

Year dc:date.issued

2018

Author dc:creator

• Eubank, Breda Hsiao Fon

Advisors dc:contributor.advisor

• Wiley, James Preston
• Lafave, Mark R.

Committee members dc:contributor.committeemember

• Mohtadi, Nicholas G. H.
• Emery, John Charles Herbert

Statement dc:rights

• University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.

Language dc:language.iso

en

DOI

http://dx.doi.org/10.11575/PRISM/34985

OAI identifier oai:identifier

oai:ucalgary.scholaris.ca:1880/109365