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* Clinical pathways are well known as a potentially powerful tool with which to organise and manage patient care. They are used in health-care organisations around the world.
* They have many benefits, such as decreasing length of stay, reducing clinical variation and costs, and improving patient outcomes.
* Much attention has been given to the development and implementation of clinical pathways, but there has been less focus on the crucial components and design features.
* We analysed 176 clinical pathways drawn from a range of settings in three countries and developed a set of criteria that identifies essential components in their design.
* This set of criteria enables healthcare staff and clinical pathway developers to place the clinical and technical content of pathways into a workable template. The template may support others in critically reviewing their existing pathways and help planners to understand the essential elements of clinical pathways.
A clinical pathway is a tool with which to support the development of structures and processes to manage clinical work while at the same time optimising resource use. Clinical pathways are employed for a wide range of purposes - as a budgeting tool, as a care planning and review tool, as a teaching tool as well as a patient management and education tool. They can strengthen coordination of care and identify accountability for patient outcomes, and they can promote multidisciplinary collaboration and communication. A range of studies show that clinical pathways, if used well, can reduce length of stay and clinical variation in terms of diagnostic and therapeutic prescriptions, without compromising the quality of care1,2.
Despite their popularity, little is known about the use of clinical pathways in an international context. Hale3 argues that clinical pathways are under-conceptualised and that they are being developed and implemented with very little understanding of what exactly it is that is being implemented. We know what clinical pathways are by definition, and we know locally what...