A qualitative survey of staff responses to an integrated care pathway pilot study in a mental healthcare setting

Abstract

This qualitative study set out to discover a multidisciplinary team's impressions of an integrated care pathway pilot. Specific aims were: to explore participants' beliefs about the effectiveness and limitations of the pilot and its impact on practice, and to use the findings to develop recommendations for the future of integrated care pathways within the clinical area. The research setting was an in-patient dementia assessment service, forming part of the mental health directorate of an NHS trust in the east of England. Data were generated through semi-structured interviews with a purposive sample of the multidisciplinary team, based on the premise that a qualitative approach develops an insider view of the team's experiences, beliefs and perceptions. Theoretical analysis was conducted, based on the analytical framework described, and facilitated through the use of QSR.NUD.IST IV content analysis software. Four categories emerged, which focused on: the clinical impact of the pathway; team performance; pathway effectiveness; and practice development. The team's impressions corroborated experiences of integrated care pathways outlined in the literature. Benefits identified by the team were the pathway's influence on managing care, increased efficiency, better team working and perceived positive impact on the experience of patient and carer. Particular new insights focused on the pathway's impact on professional roles and responsibilities. The study indicated that the pathway concept was adaptable to this mental health setting and that benefits had been derived. The study's limitations are the inherent complexities associated with validity and reliability. Recommendations relate to local evaluation of the integrated care pathway pilot and wider research considerations.