A Maturity Model for Care pathways

Over the last recent decades, increasing the quality of healthcare services while reducing costs has been among the top concerns in the healthcare landscape. Several healthcare institutions have initiated improvement programs and invested considerably in process orientation and management. Care pathways are receiving increasing attention from clinicians, healthcare managers, and academics, as a way to standardize healthcare processes to improve the safety, quality, and efficiency of healthcare services. Despite considerable literature on the definition of care pathways, to date there is no agreement on their key process characteristics and the way they traverse from an immature to a mature state. Such a model would guide healthcare institutions to assess pathways’ level of maturity and generate a roadmap for improving towards higher levels. In this paper, we propose a maturity model for care pathways that is constructed taking a generic business process maturity model as a basis. The model was refined through a Delphi study with nine domain experts to address healthcare domain specific concerns. To evaluate its validity, we applied it in assessing the maturity of a particular care pathway taking place in 11 healthcare institutions. The results indicate the usefulness of the proposed model in assessing pathway’s maturity and its potential to provide guidance for its improvement.

[1]  M. Hammer The process audit. , 2007, Harvard business review.

[2]  Jan Pries-Heje,et al.  Soft design science methodology , 2009, DESRIST.

[3]  Kevin McCormack,et al.  The development of a supply chain management process maturity model using the concepts of business process orientation , 2004 .

[4]  Jerry N. Luftman Assessing Business-IT Alignment Maturity , 2000, Commun. Assoc. Inf. Syst..

[5]  Richard J. Holden,et al.  The Technology Acceptance Model: Its past and its future in health care , 2010, J. Biomed. Informatics.

[6]  Kevin McCormack,et al.  Business Process Orientation: Gaining the E-Business Competitive Advantage , 2001 .

[7]  Alan R. Hevner,et al.  Design Science in Information Systems Research , 2004, MIS Q..

[8]  Hajo A. Reijers,et al.  Business process maturity models: a systematic literature review , 2016 .

[9]  Petter Gottschalk,et al.  Maturity levels for interoperability in digital government , 2009, Gov. Inf. Q..

[10]  Ayça Tarhan,et al.  Assessing healthcare Process Maturity: Challenges of using a Business Process Maturity Model , 2015, 2015 9th International Conference on Pervasive Computing Technologies for Healthcare (PervasiveHealth).

[11]  Fred D. Davis Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology , 1989, MIS Q..

[12]  Mark G. Schippits,et al.  Clinical pathways leading healthcare reform: transformational strategies for oncology and beyond , 2013 .

[13]  Carl S. Remmert,et al.  An Introduction to Critical Paths , 2005, Quality management in health care.

[14]  Geert Poels,et al.  Choosing the right business process maturity model , 2013, Inf. Manag..

[15]  Mary Ratcliffe,et al.  What “ideas‐about‐science” should be taught in school science? A Delphi study of the expert community , 2003 .

[16]  Kris Vanhaecht,et al.  Clinical pathway audit tools: a systematic review. , 2006, Journal of nursing management.

[17]  L. De Bleser,et al.  Defining pathways. , 2006, Journal of nursing management.

[18]  Sigifredo Laengle,et al.  Transparency-Driven Business Process Management in Healthcare Settings [Leading Edge] , 2013, IEEE Technology and Society Magazine.

[19]  Kris Vanhaecht,et al.  The Care Process Self-Evaluation Tool: a valid and reliable instrument for measuring care process organization of health care teams , 2013, BMC Health Services Research.

[20]  Paul Gemmel,et al.  Hospital Process Orientation (HPO): The development of a measurement tool , 2008 .

[21]  Marc Berg,et al.  Bridging the quality chasm: integrating professional and organizational approaches to quality. , 2005, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[22]  K. Vanhaecht The impact of clinical pathways on the organisation of care processes , 2007 .

[23]  Uzay Kaymak,et al.  A sensitivity analysis approach to introducing weight factors into decision functions in fuzzy multicriteria decision making , 1998, Fuzzy Sets Syst..

[24]  A. Donabedian An Introduction to Quality Assurance in Health Care , 2002 .

[25]  Daniel L. Moody,et al.  The method evaluation model: a theoretical model for validating information systems design methods , 2003, ECIS.

[26]  K. Zander Integrated Care Pathways: Eleven International Trends , 2002 .

[27]  Hajo A. Reijers,et al.  Do Mature Business Processes Lead to Improved Performance? - A Review of Literature for Empirical Evidence , 2015, ECIS.

[28]  Amy Van Looy An Experiment for Measuring Business Process Maturity with Different Maturity Models , 2015, ECIS.

[29]  K. Zander,et al.  Prevalence and use of clinical pathways in 23 countries – an international survey by the European Pathway Association , 2006 .

[30]  Erik Perjons,et al.  Process Oriented Information Systems Architectures in Healthcare , 2003, Health Informatics J..

[31]  K. Vanhaecht,et al.  An overview on the history and concept of care pathways as complex interventions , 2010 .

[32]  C. Powell The Delphi technique: myths and realities. , 2003, Journal of advanced nursing.

[33]  M. Panella,et al.  Reducing clinical variations with clinical pathways: do pathways work? , 2003, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[34]  Roy Wendler,et al.  The maturity of maturity model research: A systematic mapping study , 2012, Inf. Softw. Technol..

[35]  Michael Rosemann,et al.  The Six Core Elements of Business Process Management , 2015, Handbook on Business Process Management.

[36]  Roel Wieringa,et al.  Design Science Methodology for Information Systems and Software Engineering , 2014, Springer Berlin Heidelberg.

[37]  Suzanne D. Pawlowski,et al.  The Delphi method as a research tool: an example, design considerations and applications , 2004, Inf. Manag..

[38]  L. Kuntz,et al.  Process-based organization design and hospital efficiency. , 2007, Health care management review.

[39]  Michael Rosemann,et al.  Towards a Business Process Management Maturity Model , 2005, ECIS.

[40]  S Siesling,et al.  Quality improvement by implementing an integrated oncological care pathway for breast cancer patients. , 2014, Breast.

[41]  R. Brook,et al.  Consensus methods: characteristics and guidelines for use. , 1984, American journal of public health.

[42]  Jörg Becker,et al.  Maturity models in business process management , 2012, Bus. Process. Manag. J..

[43]  Fred D. Davis,et al.  A Theoretical Extension of the Technology Acceptance Model: Four Longitudinal Field Studies , 2000, Management Science.

[44]  Alain Pinsonneault,et al.  Survey Research Methodology in Management Information Systems: An Assessment , 1993, J. Manag. Inf. Syst..

[45]  Alan R. Hevner,et al.  POSITIONING AND PRESENTING DESIGN SCIENCE RESEARCH FOR MAXIMUM IMPACT 1 , 2013 .

[46]  Gordon B. Davis,et al.  User Acceptance of Information Technology: Toward a Unified View , 2003, MIS Q..

[47]  Christian Nøhr,et al.  Research needs and priorities in health informatics , 2000, Int. J. Medical Informatics.

[48]  Alan C. Gillies,et al.  Managing change in process and people: Combining a maturity model with a competency-based approach , 2003 .

[49]  K Vanhaecht,et al.  Impact of care pathways for in-hospital management of COPD exacerbation: a systematic review. , 2011, International journal of nursing studies.

[50]  Ayça Tarhan,et al.  Business Process Maturity Assessment: State of the Art and Key Characteristics , 2015, 2015 41st Euromicro Conference on Software Engineering and Advanced Applications.

[51]  Maximilian Röglinger,et al.  What makes a useful maturity model? a framework of general design principles for maturity models and its demonstration in business process management , 2011, ECIS.

[52]  P. D. Gonçalves,et al.  Hospital process orientation from an operations management perspective: development of a measurement tool and practical testing in three ophthalmic practices , 2013, BMC Health Services Research.

[53]  Tobias Mettler,et al.  HCMM - a maturity model for measuring and assessing the quality of cooperation between and within hospitals , 2012, 2012 25th IEEE International Symposium on Computer-Based Medical Systems (CBMS).

[54]  Jörg Becker,et al.  Developing Maturity Models for IT Management , 2009, Bus. Inf. Syst. Eng..