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

@article{Vanhaecht2012HaveWD,
  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},
  year={2012},
  volume={35},
  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… 

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References

SHOWING 1-10 OF 59 REFERENCES

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
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