Collaborative Healthcare Professionals Approach in Monitoring of Patient Centered Outcomes Through Pathways
Collaborative Healthcare Professionals Approach in Monitoring of Patient Centered Outcomes Through Pathways
The aim of this study is to determine if by providing a collaborative, integrated
 pathway-based healthcare compared to the usual healthcare, whether or not this would be
 superior in reducing the length of hospital stay across five high frequency /high risk
 medical diagnoses: Acute Venous Thromboembolism, Acute Kidney Injury, Community Acquired
 Pneumonia, Adult Left Ventricular Heart Failure, and Asthma.
This study is a pragmatic randomized controlled trial. To date, there is a scarcity of
 randomized controlled trials looking at pathway-based, patient-centered healthcare versus
 usual care in several high-risk or high volume diagnoses that account for the vast majority
 of hospitalizations in medical settings.

 In this study, the pathway care intervention is a collaborative effort that involves
 healthcare professionals from multiple departments, including pharmacists, health educators,
 nurses, social workers, nutritionists, and quality management.

 For patients allocated to the usual care, these healthcare professionals will deliver
 standardized care when consulted. For pathway care patients, this collaborative healthcare
 will be default.
1. Inclusion Criteria (Overall Criteria):

 -  One principle diagnosis

 -  Hemodynamic Stability

 2. Inclusion Criteria (Specific to each Diagnosis):

 Acute Venous Thromboembolism:

 -  New onset / in-patient

 Acute Kidney Injury:

 -  Patients with increased serum creatinine of more than 50% from baseline

 Community Acquired Pneumonia:

 -  Age limit

 Adult Left Ventricular Heart Failure:

 -  Age limit

 Asthma

 -  Acute exacerbation of Asthma

 3. Exclusion Criteria (Overall Criteria):

 -  Intensive Care Unit (ICU) patients

 -  Pregnancy

 4. Exclusion Criteria (Specific to each Diagnosis):

 Acute Venous Thromboembolism:

 -  Hemodynamic instability (Systolic Blood Pressure (SBP) less than 90 mmHg or massive
 Pulmonary Embolism (PE)

 -  PE patients with an sPESI Score ≥ 1

 Acute Kidney Injury:

 -  Critical care patients (ICU, Coronary Care Unit, burn units)

 -  Stage 4 and 5 chronic kidney diseases

 -  Kidney allograft recipients

 -  Obstructive uropathy

 -  Glomerulonephritis

 -  Interstitial nephritis

 Community Acquired Pneumonia:

 -  Intensive Care Unit (ICU) patients

 -  Pregnancy

 Adult Left Ventricular Heart Failure:

 -  All non-cardiogenic pulmonary edema

 -  Patients requiring Inotropic agents

 Asthma

 -  Patients with Chronic Obstructive Pulmonary Disease (COPD) and Bronchiectasis

 -  Severe Asthma (Peak Expiratory Flow Rate (PEFR) less than 40 percent)