The Development of an Integrated Care Pathway for Schizophrenia

The Centre for Addiction and Mental Health (CAMH)

The Challenge

The healthcare system in Ontario is undergoing a period of significant change. Patients and families are increasingly sophisticated consumers of healthcare and have correspondingly high expectations. Patients expect care decisions to be made on the basis of evidence and best practices. Notably, that would means patients who have the same conditions would receive similar treatment regardless of where they receive service. A number of high profile cases have helped to raise concerns about quality of care that patients receive and its consistency within hospitals and across regions and the country. Differences in practice between clinicians within the same organization and across organizations can lead to variable patient care experiences and outcomes. In response to these concerns, there is a new emphasis on the standardization of care that is cost effective, minimizes risks and inappropriate costs and is of the highest quality of care. The development of Integrated Care Pathway (ICP) has been identifies as a strategic priority for the Centre of Addiction and Mental Health (CAMH).

The Improvement Project

Through the use of ICPs, CAMH will create sustainable change in care delivery to improve quality, safety and services for people with mental health and addiction issues. The development of ICPs is in its infancy in Ontario, especially in the field of mental health and addictions. That being said, ICPs will help CAMH improve our assessment and treatment planning, ensure that care is delivered in accordance with evidence and best practices, and get our patients that right care and treatment at the right time. As a first step in this ambitious undertaking, this project will focus on the development of an ICP for patients with schizophrenia, an illness which has a profound impact on patients, their families and the health care system. Following the appointment of a steering committee and an assessment of current practices, a clinical pathway design and development team will be assembled. This group will responsible for the design and development of the clinical pathway document and variance management system. An analysis of the difference between actual versus expected practice will serve as the foundation for an education plan for clinicians. Once completed, the ICP for schizophrenia will be piloted and an initial evaluation of the utility of the ICP will be carried out. Results will be used to fine tune and adapt the care pathway and a phased in implementation strategy will be developed.