Improving Customisation in Clinical Pathways by Using a Modular Perspective

Anne van Dam, Margot Metz and Bert Meijboom
Additional contact information
Anne van Dam: McCoy & Partners, Torenallee 45, 5617 BA Eindhoven, The Netherlands
Margot Metz: GGz Breburg, Specialist Mental Health Care Organisation, P.O. Box 770, 5000 AT Tilburg, The Netherlands
Bert Meijboom: Scientific Centre Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands

IJERPH, 2021, vol. 18, issue 21, 1-9

Abstract: A standardised system of clinical pathways often conflicts with providing patient-centred heterogeneous care. Mental health care organisations are searching for new methods to become responsive towards unique treatment needs. Modularity is a method increasingly suggested to reconcile standardisation and customisation. The aim is to investigate the extent to which modularity can be applied to make clinical pathways in specialist mental health care more flexible in order to stimulate shared decision making (SDM) and thereby customise care processes to patient contexts while maintaining evidence-based standards. Methods consist of literature research and a theory-based case study including document analysis and semi-structured interviews, which were performed at a Dutch specialist mental health care organisation. The results show that in current literature two modularity-based structures are proposed that support flexibility and customisation, i.e., ‘Prototype’ and ‘Menu-based’. This study reveals that departments tend to use the prototype method if they have predictable patient needs, evidence-based methods are available and there is sequency in treatment components. The menu-based method is preferred if there are unpredictable needs, or the evidence needed to create interconnectedness in treatment is lacking. In conclusion, prototype or menu-based methods are both suitable for applying SDM and reaching customisation in practice. The choice is determined by three characteristics: predictability of needs, availability of evidence and the interconnectedness of treatment components.

Keywords: shared decision making; patient-centred care; evidence-based practice; clinical guidelines; modularity; specialist mental health care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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