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

Citation

Lawal, AK and Rotter, T and Kinsman, L and Machotta, A and Ronellenfitsch, U and Scott, SD and Goodridge, D and Plishka, C and Groot, G, What is a clinical pathway? Refinement of an operational definition to identify clinical pathway studies for a Cochrane systematic review, BMC Medicine, 14 Article 35. ISSN 1741-7015 (2016) [Refereed Article]


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© 2016 Lawal et al. Licensed under Creative Commons Attribution 4.0 International (CC BY 4) http://creativecommons.org/licenses/by/4.0/

DOI: doi:10.1186/s12916-016-0580-z

Abstract

Clinical pathways (CPWs) are a common component in the quest to improve the quality of health. CPWs are used to reduce variation, improve quality of care, and maximize the outcomes for specific groups of patients. An ongoing challenge is the operationalization of a definition of CPW in healthcare. This may be attributable to both the differences in definition and a lack of conceptualization in the field of clinical pathways. This correspondence article describes a process of refinement of an operational definition for CPW research and proposes an operational definition for the future syntheses of CPWs literature. Following the approach proposed by Kinsman et al. (BMC Medicine 8(1):31, 2010) and Wieland et al. (Alternative Therapies in Health and Medicine 17(2):50, 2011), we used a four-stage process to generate a five criteria checklist for the definition of CPWs. We refined the operational definition, through consensus, merging two of the checklist’s criteria, leading to a more inclusive criterion for accommodating CPW studies conducted in various healthcare settings. The following four criteria for CPW operational definition, derived from the refinement process described above, are (1) the intervention was a structured multidisciplinary plan of care; (2) the intervention was used to translate guidelines or evidence into local structures; (3) the intervention detailed the steps in a course of treatment or care in a plan, pathway, algorithm, guideline, protocol or other ‘inventory of actions’ (i.e. the intervention had time-frames or criteria-based progression); and (4) the intervention aimed to standardize care for a specific population. An intervention meeting all four criteria was considered to be a CPW. The development of operational definitions for complex interventions is a useful approach to appraise and synthesize evidence for policy development and quality improvement.

Item Details

Item Type:Refereed Article
Keywords:evidence-based practice, primary health care, systematic review, clinical pathways
Research Division:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Health Care Administration
Objective Division:Health
Objective Group:Health and Support Services
Objective Field:Health and Support Services not elsewhere classified
Author:Kinsman, L (Professor Leigh Kinsman)
ID Code:106902
Year Published:2016
Web of Science® Times Cited:2
Deposited By:Health Sciences
Deposited On:2016-02-25
Last Modified:2017-12-05
Downloads:148 View Download Statistics

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