Design and development of a digital diagnostic clinical pathway: evidence from an action research study

Armando Calabrese, Antonio D'Uffizi, Nathan Levialdi Ghiron, Luca Berloco, E. Pourabbas, Nathan Proudlove
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Abstract

PurposeThe primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.Design/methodology/approachThe methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.FindingsThe methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.Originality/valueThe study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.
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数字诊断临床路径的设计与开发:一项行动研究的证据
目的本文的主要目的是展示医疗保健领域关键临床路径(CP)数字化的系统化方法。在此框架内,利益相关者通过半结构化访谈参与进来,同时使用 BPMN 2.0 划分和表示现有和设想的流程。这些方法步骤强调开发一个自主的、以病人为中心的网络应用程序,同时实施一个适应性强的、以病人为导向的排班系统。此外,还采用业务流程模拟来衡量流程的关键绩效指标,并测试潜在的改进措施。研究结果该方法将 SD 和 AR 相结合,能够发现诊断中心内的关键瓶颈,并提出最佳纠正措施,以确保不间断的患者护理,同时推进诊断中心管理的数字化。本研究通过强调流程优化的关键性、医疗保健数字化的变革潜力以及以用户为中心的设计原则的极端重要性,为理论讨论做出了贡献,并为医疗保健管理的意义提供了宝贵的见解。这种务实的方法符合医疗机构以高效、经济的方式改善运营的迫切需要,因此研究结果具有现实意义。
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