Developing Care Pathways

Luc, Kathryn de; Kitchiner, Denise; Layton, Amanda; Morris, Elaine L.; Murray, Yvonne; Overill, Sue

doi:10.4324/9781315379166

Cited by 4 publications

(9 citation statements)

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“…66 Our results corroborate that CPW terminology is inconsistently used in the existing literature, and may cause confusion when evaluating a study. 1,10,14,16 Among the 44 included publications, 10 separate terms were used to describe the intervention, including eight publications where two different terms were used simultaneously and/or interchangeably. Furthermore and perhaps compounding the confusion, the authors often interchanged these two different terms at random between the title, abstract, figures, tables, and text.…”

Section: Protocolmentioning

confidence: 99%

“…First, at present, a lack of definite consensus of what a clinical pathway actually constitutes, and the heterogeneity of terms used to denote CPWs, makes the systematic identification of primary studies for review purposes challenging. 1,14 For example, the strict multidisciplinary inclusion criteria inherent in using these novel criteria resulted in many ED publications being excluded. We took multidisciplinary to mean intimate involvement at the inter-personal level in the organization of care processes, in line with the interpretation of Rotter et al.…”

Section: Limitationsmentioning

confidence: 99%

“…1,6,7 Two main features of CPWs set them apart from other complex interventions. 1,[8][9][10][11][12][13][14][15] First, they take evidence from general recommendations, such as clinical practice guidelines, and they transform these into structured local clinical practices. Second, these interventions utilize a multidisciplinary approach to patient care.…”

Section: Introductionmentioning

confidence: 99%

“…These include terms such as critical pathway, care map, and integrated care pathway. 1,14 While developing the protocol for a systematic review, Kinsman et al 12 observed that the existing CPW definitions were not specific enough to guide a systematic literature search strategy, and lacked the precision to maximize the inter-rater agreement of CPW study selection. 16 For example, the European Pathway Association (EPA) definition may be considered adequate for use in health care service delivery, but its use in research applications has been questioned.…”

Section: Introductionmentioning

confidence: 99%

“…These include terms such as critical pathway, care map, and integrated care pathway. 1,14 While developing the protocol for a systematic review, Kinsman et al. 12 observed that the existing CPW definitions were not specific enough to guide a systematic literature search strategy, and lacked the precision to maximize the inter-rater agreement of CPW study selection.…”

Section: Introductionmentioning

confidence: 99%

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Validation of descriptive clinical pathway criteria in the systematic identification of publications in emergency medicine

Adjemian

Zirkohi

Coombs

et al. 2017

International Journal of Care Coordination

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Background: Heterogeneity in both the definition and terminology of clinical pathways presents a challenge to the systematic identification of primary studies for review purposes. Recently developed clinical pathway identification criteria may facilitate both the identification and assessment of clinical pathway studies. The goal of this publication is the validation of these five criteria in a descriptive systematic review of actively implemented clinical pathway studies in the emergency department setting. The main outcome measure is the inter-rater agreement of investigators using the clinical pathway criteria. Methods: We performed a systematic literature search from 2006 to 2015 using MEDLINE, EMBASE, CENTRAL, and CINAHL. All types of prospective trial designs were eligible. We identified relevant publications using the above-mentioned clinical pathway criteria. Two reviewers independently collected data using a piloted data abstraction tool. Results: We identified 5947 publications, with 472 potentially relevant full text publications retrieved. Of these, 357 did not meet preliminary study inclusion criteria, leaving 115 publications where the clinical pathway criteria were applied. Ultimately, 44 publications were included. The inter-rater agreement of the criteria was very good (k ¼ 0.81, 95% Confidence Interval ¼ 0.70-0.92). The vast majority of studies were excluded because the intervention did not meet the criterion of being multidisciplinary in nature. Conclusion: These criteria are a useful instrument to reliably identify clinical pathway publications for systematic review purposes in an emergency department setting. Future modification of these criteria may improve their usefulness. Particular attention should be placed on clarifying what is meant by multidisciplinary involvement within the context of clinical pathway interventions, with specific emphasis placed on delineating the level of involvement of each discipline and their decision-making responsibility.

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Section: Protocolmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Validation of descriptive clinical pathway criteria in the systematic identification of publications in emergency medicine

Adjemian

Zirkohi

Coombs

et al. 2017

International Journal of Care Coordination

View full text Add to dashboard Cite

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A survey of OR/MS models on care planning for frail and elderly patients

Williams

Gärtner

Harper

2021

Operations Research for Health Care

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Clinical pathway modelling: a literature review

2019

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Hospital information systems are increasingly used as part of decision support tools for planning at strategic, tactical and operational decision levels. Clinical pathways are an effective and efficient approach in standardising the progression of treatment, to support patient care and facilitate clinical decision making. This literature review proposes a taxonomy of problems related to clinical pathways and explores the intersection between Information Systems (IS), Operational Research (OR) and industrial engineering. A structured search identified 175 papers included in the taxonomy and analysed in this review. The findings suggest that future work should consider industrial engineering integrated with OR techniques, with an aim to improving the handling of multiple scopes within one model, while encouraging interaction between the disjoint care levels and with a more direct focus on patient outcomes. Achieving this would continue to bridge the gap between OR, IS and industrial engineering, for clinical pathways to aid decision support.

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Developing Care Pathways

Cited by 4 publications

References 0 publications

Validation of descriptive clinical pathway criteria in the systematic identification of publications in emergency medicine

Validation of descriptive clinical pathway criteria in the systematic identification of publications in emergency medicine

A survey of OR/MS models on care planning for frail and elderly patients

Clinical pathway modelling: a literature review

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