Development and implementation of a clinical pathway programme in an acute care general hospital in Singapore

Abstract

A critical or clinical pathway defines the optimal care process, sequencing and timing of interventions by doctors, nurses and other health care professionals for a particular diagnosis or procedure. Clinical pathways are developed through collaborative efforts of clinicians, case managers, nurses, pharmacists, physiotherapists and other allied health care professionals with the aim of improving the quality of patient care, while minimizing cost to the patient. The use of clinical pathways has increased over the past decade in the USA, the UK, Australia, and many other developed countries. However, its use in the developing nations and Asia has been sporadic. To the author's knowledge, there is to date, no published literature on the use and impact of clinical pathways on the quality and cost of patient care in the Asian health care setting. This paper provides a qualitative account of the development and implementation of a clinical pathway programme (using the example of patients with uncomplicated acute myocardial infarction) in an acute care general hospital in Singapore. The paper concludes that clinical pathways, when implemented in the context of an acute care hospital, can result in improvements in the care delivery process.

Development and Long Term Evaluation of a Critical Pathway for the Management of Microvascular Decompression

“…Some pressure is currently being exerted to develop guidelines by which the management of many medical and surgical conditions can be improved (Cheah, 2000;Mitchell et al, 2005;Park & Ro, 2000). We developed a CP for patients with HFS and TN who underwent MVD.…”

“…The total cost per patient for step II marked an average annual increase of 6.2%. This was attributed to rising medical costs per person in Korea (9.3%) between the year 2000(Ministry of Health and Welfare, 2013. This suggested an increased profit rate of the hospital and confirmed the 1999 proposal of Rohrbach.…”

“…Meanwhile, variations during the period of 2003 to 2009 were observed in 12 items: observation/measurement 1, medication 8, and lab & test 3. This is a very important reason to develop CP (Cheah, 2000;Panella et al, 2003).…”

Reconfigurable modelling with deadlock avoidance for the clinical pathway based on MCPN-CS

“…5 and Table VI. The CBC process for composing the ACPN 2,3 into MCPN-CS 2,3 are exactly the same as the above Examples, the details of the CBC process are omitted here. The above steps and their corresponding control measures may lead to final marking, which indicates the completion of the osteosarcoma preoperative chemotherapy.…”

“…Clinical pathway (CP) is a management plan that displays goals for patients and provides the sequence and timing of actions necessary to achieve these goals with optimal efficiency [1,2]. After being introduced by Zander into medical care in early 1980s, it has been widely applied in hospitals and medical care communities [3,4].…”