Pathways

What are pathways?

Integrated care pathways, clinical pathways, patient journeys and care maps are interchangeable terminology used to describe tools which promote organised and efficient patient care based on the best available evidence and guidelines (Kwan et al., 2004).

A clinical pathway can further be described as a ‘complex intervention for the mutual decision making and organisation of care processes for a well-defined group of patients during a well-defined period’ (European Pathway Association, 2007). The use of clinical pathways allows continuous assessment of clinical processes and outcomes against current best practice and guidelines.

In order to define what constitutes a care pathway, a team of Cochrane Review authors developed a five-part criteria in which the first and three of the other four criteria must be met in order to be defined as a ‘clinical pathway’ (Kinsman et al, 2011).  The five criteria are:

• the intervention was a structured multidisciplinary plan of care
• the intervention was used to translate guidelines or evidence into local structures
• the intervention detailed the steps in a course of treatment or care in a plan, pathway, algorithm, guideline, protocol or other ‘inventory of actions’
• the intervention had timeframes or criteria-based progression
• the intervention aimed to standardise care for a specific clinical problem, procedure or episode of healthcare in a specific population