Critical pathway: Difference between revisions

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| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=10691588 }}</ref><ref name="pmid7486490">{{cite journal| author=Pearson SD, Goulart-Fisher D, Lee TH| title=Critical pathways as a strategy for improving care: problems and potential. | journal=Ann Intern Med | year= 1995 | volume= 123 | issue= 12 | pages= 941-8 | pmid=7486490  
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=10691588 }}</ref><ref name="pmid7486490">{{cite journal| author=Pearson SD, Goulart-Fisher D, Lee TH| title=Critical pathways as a strategy for improving care: problems and potential. | journal=Ann Intern Med | year= 1995 | volume= 123 | issue= 12 | pages= 941-8 | pmid=7486490  
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=7486490 }}</ref>
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=7486490 }}</ref>
Measuring adherence is difficult.<ref name="pmid20696277">{{cite journal| author=van de Klundert J, Gorissen P, Zeemering S| title=Measuring clinical pathway adherence. | journal=J Biomed Inform | year= 2010 | volume= 43 | issue= 6 | pages= 861-72 | pmid=20696277 | doi=10.1016/j.jbi.2010.08.002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20696277  }} </ref>


==Effectiveness==
==Effectiveness==

Revision as of 11:56, 7 April 2011

In health care, critical pathways are "schedules of medical and nursing procedures, including diagnostic tests, medications, and consultations designed to effect an efficient, coordinated program of treatment."[1][2][3]

Measuring adherence is difficult.[4]

Effectiveness

"Clinical pathways are associated with reduced in-hospital complications and improved documentation without negatively impacting on length of stay and hospital costs." according to a meta-analysis by the Cochrane Collaboration.[5]

As examples, a critical pathway may improve the outcomes of pneumonia[6], chest pain[7][8], and maybe stroke[9].

References

  1. ↑ Anonymous (2024), Critical pathway (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ Morris AH (2000). "Developing and implementing computerized protocols for standardization of clinical decisions.". Ann Intern Med 132 (5): 373-83. PMID 10691588.
  3. ↑ Pearson SD, Goulart-Fisher D, Lee TH (1995). "Critical pathways as a strategy for improving care: problems and potential.". Ann Intern Med 123 (12): 941-8. PMID 7486490.
  4. ↑ van de Klundert J, Gorissen P, Zeemering S (2010). "Measuring clinical pathway adherence.". J Biomed Inform 43 (6): 861-72. DOI:10.1016/j.jbi.2010.08.002. PMID 20696277. Research Blogging.
  5. ↑ Rotter T, Kinsman L, James E, Machotta A, Gothe H, Willis J et al. (2010). "Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costs.". Cochrane Database Syst Rev (3): CD006632. DOI:10.1002/14651858.CD006632.pub2. PMID 20238347. Research Blogging. Review in: Ann Intern Med. 2010 Aug 17;153(4):JC2-12
  6. ↑ Marrie TJ, Lau CY, Wheeler SL, Wong CJ, Vandervoort MK, Feagan BG (2000). "A controlled trial of a critical pathway for treatment of community-acquired pneumonia. CAPITAL Study Investigators. Community-Acquired Pneumonia Intervention Trial Assessing Levofloxacin". JAMA 283 (6): 749-55. PMID 10683053. [e]
  7. ↑ Reilly BM, Evans AT, Schaider JJ, Das K, Calvin JE, Moran LA et al. (2002). "Impact of a clinical decision rule on hospital triage of patients with suspected acute cardiac ischemia in the emergency department.". JAMA 288 (3): 342-50. PMID 12117399.
  8. ↑ Nichol G, Walls R, Goldman L, Pearson S, Hartley LH, Antman E et al. (1997). "A critical pathway for management of patients with acute chest pain who are at low risk for myocardial ischemia: recommendations and potential impact.". Ann Intern Med 127 (11): 996-1005. PMID 9412306.
  9. ↑ Kwan J, Sandercock P (2004). "In-hospital care pathways for stroke.". Cochrane Database Syst Rev (4): CD002924. DOI:10.1002/14651858.CD002924.pub2. PMID 15495038. Research Blogging.
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