Better pathways for people with aphasia

Worrall, Linda Elizabeth and Thomas, Emma Elizabeth and Rohde, Alexia and Rose, Miranda and Togher, Leanne and Ferguson, Alison (2013) Better pathways for people with aphasia. [Clinical Aphasiology Paper]

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Abstract

Integrated care pathways, clinical pathways, patient journeys and care maps are interchangeable terminology to describe tools which promote organised and efficient patient care based on the best available evidence and guidelines (Kwan et al., 2004). A care pathway can further be described as a ‘complex intervention for the mutual decision making and organisation of care processes for a well-defined group of patients during a well-defined period’ (European Pathway Association, 2007). The use of care pathways allows continuous assessment of clinical processes and outcomes against current best practice and guidelines. As evidence-based practice become progressively more important for effective health delivery, increased research use within aphasia rehabilitation is paramount. Currently, stroke clinical guidelines offer very little in the form of aphasia-specific recommendations to inform practice. Our systematic review of clinical practice guidelines revealed a paucity of high-quality aphasia rehabilitation guidelines internationally (Rohde et al, in press). Integrated care pathways are gaining increasing popularity in health care delivery and offer a potential solution to the lack of evidence-based recommendations within aphasia rehabilitation. The AARP aims to improve the overall patient journey for people with aphasia through providing clinicians with access to the best evidence in a dynamic and user-friendly format. In addition to the principles of integrated care pathways, the AARP utilises the theory of evidence-based practice through combining the best available evidence with family/client perspectives and clinical expertise. The AARP is also underpinned by the principles of knowledge transfer and exchange (KTE) which aims to close the research-practice gap in order to realise and maximise the benefits of research within the practice setting. Hence the aims of this paper are to: a) Present results of the systematic review of clinical guidelines in stroke and aphasia b) Describe the consensus document that maps the AARP. c) Describe the translation of a highly complex system to a user-friendly web-based system.

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