INTEGRATED CARE PATHWAYS IN MULTIPLE-SCLEROSIS REHABILITATION - COMPLETING THE AUDIT CYCLE

The rehabilitation of progressive neurological disorders, such as Mult iple Sclerosis (MS) requires comprehensive, expert management which is demanding of both time and resources. Mechanisms to monitor and audit both process and outcome are therefore essential. Integrated core pat hways (ICPs) which detail the expected interventions during a given ep isode of clinical core, provide such a mechanism. In this study three cohorts of patients (totalling 125 episodes) with clinically definite Progressive MS underwent a rehabilitation programme audited through IC Ps. The cohorts were similar in relation to disability and age. Variat ions (departures from the expected pathway) were documented for both t he rehabilitation process and goal achievement Duration of stay reduce d from 28 days for the first cohere to 18 days for the third and there was greater multidisciplinary input and carer involvement over time. Goal achievement increased from 79% for the first cohort to 87% for th e third and there was on increased emphasis on cognitive function and fatigue management in relation to goal\s set ICPs provide on excellent mechanism for closing the audit loop and have the potential to ploy o n important role in improving service provision in MS.