Objective

Care programs in MPR formalize, for homogeneous profile of patients the steps of a multidisciplinary approach based on the rehabilitation potential and focused on improving functional status. The aim is to build a custom clinical pathway for patients with stroke followed in Physical Medicine and Rehabilitation Day Hospital by connecting each step systematically formalized a traceability tool in the information system in view a fair payment of a care program.

Material/patients and methods

Our outpatient hospital PMR team has built a clinical pathway according the method of the High Authority of Health, supported by MPR criteria defined by FEDMER and texts regulating the activity of French post-acute care (SSR). The related group of patients is the second category of patients defined in the document care course PRM “the patient after stroke”. In accordance with professional practices based on evidence, the plan of care for these patients includes standard steps associated with custom steps as needed. The steps of the clinical pathway were connected with French tools “CSARR” or “CCAM”.

Results

Our clinical path includes standardized assessment phases, initial, intermediate and final and personalized care phases adapted to each case. The majority of the steps can be traced by the activity description tools. The pathway provides medical coherence to the whole procedure of care. According to the team, the criteria of evaluation of the clinical pathway target the critical steps.

Discussion – conclusion

The clinical pathway is a translation of a care program in the information system. This is to be the result of the clinical approach of caregivers. If the doctor is too transparent to PMSI-SSR, as well as all intellectual acts, on the eve of the implementation of the modulated staffing activity, clinical pathway is the way to link the relevance of care program to a patient classification system for its valuation at the right cost.