Mapping the Clinical Pathway for Patients Undergoing Vestibular Schwannoma Resection.

Background: The introduction of the electronic health record (EHR) has improved the collection and storage of patient information, enhancing clinical communication and academic research. However, EHRs are limited by data quality and the time-consuming task of manual data extraction. This study aimed to use process mapping to help identify critical data entry points within the clinical pathway for patients with vestibular schwannoma (VS) ideal for structured data entry and automated data collection to improve patient care and research.

Methods: A 2-stage methodology was used at a neurosurgical unit. Process maps were developed using semi-structured interviews with stakeholders in the management of VS resection. Process maps were then retrospectively validated against EHRs for patients admitted between August 2019 and December 2021, establishing critical data entry points.

Results: In the process map development, 20 stakeholders were interviewed. Process maps were validated against EHRs of 36 patients admitted for VS resection. Operative notes, surgical inpatient reviews (including ward rounds), and discharge summaries were available for all patients, representing critical data entry points. Areas for documentation improvement were in the preoperative clinics (30/36; 83.3%), preoperative skull base multidisciplinary team (32/36; 88.9%), postoperative follow-up clinics (32/36; 88.9%), and postoperative skull base multidisciplinary team meeting (29/36; 80.6%).

Conclusions: This is a first use to our knowledge of a 2-stage methodology for process mapping the clinical pathway for patients undergoing VS resection. We identified critical data entry points that can be targeted for structured data entry and for automated data collection tools, positively impacting patient care and research.