Nid yw'r tudalen hwn ar gael yn Gymraeg ar hyn o bryd. Dyma'r fersiwn Saesneg.

Llwybrau a Mesurau Canlyniadau

Local Health Boards are required to have in place pathways, and outcome measures for Stroke, Myocardial Infarction, Sepsis and Fractured neck of femur as a minimum.
 
The intended outcome is that patients’ experience and outcomes are improved across the whole system.

Health Boards should develop local pathways for high volume, high impact USC/Ambulatory Care Sensitive conditions using:
  • Annual Quality Framework, evidence base, activity data
  • Links with:
    • Chronic Disease Management /Community Response Team
      developments
    • WAST pressures: falls, shortness of breath, chest pain, loss of consciousness
  • Pathways & USC service plans need to consider sustainability:
    • Clinical standards/outcomes
    • Workforce: recruitment & retention/rotas
    • Critical mass/site configuration
Just as the volume and timing of overall USC activity is largely predictable; the conditions that are high volume/ high impact are readily identifiable. Health Boards should use existing clinical experience and data bases in order to inform local clinical pathway development, implementing learning from the Stroke Pathway and 1,000 Lives (bundle variance management) methodology.

An essential starting point will be to agree locally what the definition of a pathway is, the term is used interchangeably for Commissioning, Planning, Service Plans, Integrated Care Pathways (e.g. acute stroke) and more detailed, care pathways (e.g. Map of Medicine). Pathways are not a panacea (e.g. for complex, multi-factorial care) but the application of variance management to the relatively small number of critical clinical activities within each care bundle can improve clinical effectiveness, safety, efficiency and cost.

At Health Board level clarity on major, specialty based service plans and clinical pathway re design will be informed by sustainability criteria (clinical quality/ governance, sub specialisation and workforce resource) and, in turn, inform the future configuration of local, regional and national clinical services.

Public Health expertise will be required for both Service and Pathway development. And also to ensure that appropriate attention is paid to the prevention and amelioration of conditions that lend themselves to management pre-Front Door but, currently impact heavily on the USC system (e.g. alcohol and substance misuse, violence and aggression).