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

  title={Is there a future for pathways? Five pieces of the puzzle},
  author={Kris Vanhaecht and Massimiliano Panella and Ruben van Zelm and Walter Sermeus},
  journal={International Journal of Care Pathways},
  pages={82 - 86}
In this discussion and opinion paper, the Bureau members of the European Pathway Association present five challenges for the future of care pathways. Pathways will have to be based on the latest available evidence and international databases, and tools will have to be available. If pathways have a future, the organisations should focus on disease-specific oriented care. Evidence-based pathways, which are organised in a disease-specific oriented organisation, can lead to improvement of quality… 

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.

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.

The future for care pathways

The following is an invited commentary on the paper by Vanhaecht et al., which raised the question, ‘Is there a future for care pathways’, and is intended to contribute to further debate on the

Are project presentations important?

In the previous issues of this journal, we have discussed the need for knowledge sharing and research on pathways as complex interventions. Other papers have also recently been discussing that if we

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.

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

To fully understand the potential and problems of care pathways, it is important to define exactly what the authors are talking about, whether the study methods are appropriate, and whether the outcomes can properly define the outcomes.

Management challenges in care pathways: Conclusions of a qualitative study within 57 health-care organizations

The study revealed that the most important objectives for introducing care pathways are more standardization and quality of care and there is a need for more ICT support for care pathways.

Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews

None of the 300 instruments retrieved could be considered a gold standard mainly because they did not cover all the critical pathway domains outlined by Leuven and Health Technology Assessment, but this overview shows important insights for the definition of a multiprinciple framework of core domains for assessing the quality of pathways.

The European Quality of Care Pathway (EQCP) Study: history, project management and approach

The history, project management and overall approach of the European Quality of Care Pathway study, the first, international, cluster randomized controlled trial launched to study the effect of the implementation of care pathways, are described.

Roles of Pathway-Based Models and their Contribution to the Redesign of Health-Care Systems

It can be concluded that sophisticated models can be useful, in some applications; however, the simpler approaches may often be the best, offering rapid, transparent recommendations based on a multidisciplinary approach.



Prevalence and use of clinical pathways in 23 countries – an international survey by the European Pathway Association

The survey showed that clinical pathways were predominantly viewed as a multidisciplinary tool to improve the quality and efficiency of evidence-based care and were also used as a communication tool between professionals to manage and standardize outcome-oriented care.

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.

The Leuven Clinical Pathway Compass

A vast amount of literature exists on clinical pathways. When reviewing literature from 2000-2002 on Medline, 597 articles about 'clinical pathways' were found. Only 22% of these articles included

Reducing clinical variations with clinical pathways: do pathways work?

  • M. PanellaS. MarchisioF. Di Stanislao
  • Medicine, Political Science
    International journal for quality in health care : journal of the International Society for Quality in Health Care
  • 2003
The results demonstrated that it is possible to achieve the overall purpose of clinical pathways to improve outcome by providing a mechanism to coordinate care and to reduce fragmentation, and ultimately cost.

Clinical pathway audit tools: a systematic review.

Whether clinical/care pathway audit tools can identify the characteristics of well-organized care processes and the Integrated Care Pathway Appraisal Tool is the most appropriate audit tool to assess clinical pathway documents is investigated.

Development and validation of a care process self-evaluation tool

A Care Process Self-Evaluation Tool (CPSET), based on the clinical pathway concept, for assessing the organization of the process of care has been developed and tested and will help managers and clinicians to understand better how care processes are organized.

Methods for incorporating patients' views in health care

Some of the important issues related to measuring patients' views and evaluating their use in improving health care are described.

Effect of Introducing a Care Pathway to Standardize Treatment and Nursing of Schizophrenia

The authors concluded the positive outcomes for patients treated with care pathways were related to the assistance provided to clinicians in identifying and implementing evidence-based standards.

How physicians can change the future of health care.

Value-based competition on results provides a path for reform that recognizes the role of health professionals at the heart of the system and returns the practice of medicine to its appropriate focus: enabling health and effective care.

Developing evidence-based clinical indicators: a state of the art methods primer.

  • J. Mainz
  • Medicine
    International journal for quality in health care : journal of the International Society for Quality in Health Care
  • 2003
Using clinical indicators for quality assessment represents an important approach to documenting the quality of care and underlines the fact that clinical indicators must be developed and tested with scientific rigor in a transparent process.