Have We Drawn the Wrong Conclusions About the Value of Care Pathways? Is a Cochrane Review Appropriate?

  title={Have We Drawn the Wrong Conclusions About the Value of Care Pathways? Is a Cochrane Review Appropriate?},
  author={Kris Vanhaecht and John Ovretveit and Martin J. Elliott and Walter Sermeus and John Ellershaw and Massimiliano Panella},
  journal={Evaluation \& the Health Professions},
  pages={28 - 42}
Care pathways are used increasingly worldwide to organize patient care. However, different views exist about their effectiveness. One of the reasons for this is that pathways are complex interventions. A recent Cochrane review was published which reported positive results, but although the Cochrane team performed excellent work with an enormous commitment, the conclusions may be inappropriate. To fully understand the potential and problems of care pathways, it is important to define (a) exactly… 

Why is the International Journal of Care Pathways ready for Medline?

The aim is to produce a leading international peerreviewed journal, which focuses on the issues of the growing area of implementation research related to care pathways (also known as clinical pathways, critical pathways or integrated care pathways) and the organization of care processes.

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A recent study showed a large variation in the evidencebased content of care pathway documents (CPD) used for THA, leading to quality and patient safety problems.

Effects of care pathways on the in-hospital treatment of heart failure: a systematic review

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It is shown that, even for highly predictable medical conditions, there are huge differences in the evidence-based content and structure of pathways.

Can Clinical Pathways be Developed to Offer Assistance in Child Care Cases

The first step in developing a pathway which may assist in the very difficult process of deciding the level of contact to birth parents of children after their removal from their care is reported on.

Clinical and operational insights from data-driven care pathway mapping: a systematic review

It is indicated that methods utilising data-driven determination of de facto patient care pathways can provide empirical information relevant to healthcare planning, management, and practice.

What is a clinical pathway? Refinement of an operational definition to identify clinical pathway studies for a Cochrane systematic review

A process of refinement of an Operational definition for CPW research is described and an operational definition for the future syntheses of CPWs literature is proposed.

The 7-phase method to design, implement and evaluate care pathways

This paper is the first publication defining the detailed steps to design care pathways, and can offer support to multidisciplinary teams (re)designing and implementing safe, efficient, effective, person-centered, timely, equitable, continuous and integrated care processes.

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How hospital staff cope with the increased focus on meeting CPP target times and the measures and strategies implemented by hospitals and their staff are described.



Is there still need for confusion about pathways?

Care pathways are one of the tools to bring patient-focused care into daily practice by bringing the service line per patient group or medical condition to the foreground, and the professional disciplines and business units as processes or centres to the background in support of this service line.

An overview on the history and concept of care pathways as complex interventions

An overview on the history of pathways and how pathways are actually perceived and defined is provided to provide an extensive list of references that should support pathway facilitators, clinicians, managers and policy-makers in their search for excellence.

Are different models of care pathways being developed

Using the results from a survey of healthcare organisations, which are members of the National Pathways Association (NPA), the author suggests that different models of care pathways are being implemented.

What is a clinical pathway? Development of a definition to inform the debate

The criteria used for the identification of relevant studies for this Cochrane Review can be used as a foundation for the development of a standardised, internationally accepted definition of a clinical pathway.

Critical Pathways as a Strategy for Improving Care: Problems and Potential

In recent years, intense pressures to reduce the costs of health care have led many health care organizations to seek strategies that reduce resource utilization while maintaining the quality of care

Effects of Clinical Pathways: Do They Work?

The majority of the literature concluded that positive effects result from the implementation of clinical pathways, and on a macro level clinical pathways result globally in positive effects.

Is there a future for pathways? Five pieces of the puzzle

Evidence-based pathways, which are organised in a disease-specific oriented organisation, can lead to improvement of quality and efficiency but only if the authors invest in real teamwork, and the last piece of the future pathway puzzle is the need for patient involvement.

Care pathways and organizational systems: the basis for a successful connection

Care pathways have proved to be effective as a learning tool both at professional (individual) and organizational (team) level and this is probably due to a developing system of care pathways that are based on several shared steps that provide an ideal opportunity for people involved to receive and to share a clinically based education.

Do pathways lead to better organized care processes?

This is the first study to analyse how healthcare teams perceive the organization of care processes with respect to clinical pathways and the findings are important for other quality improvement methods.

Making clinical governance work.

This paper summarises a conference that took place at the Royal College of Physicians about the work of the Clinical Effectiveness and Evaluation Unit (CEEu) and the National Collaborating Centre for