Clinical Care Pathways

Care pathways, also known as clinical pathways or integrated care pathways, are typically characterized as a method for managing patient care based on clinical practice guidelines, with the main goals of improving quality of care, reducing variation in clinical practice and increasing the efficient use of health care resources.

The use of care pathways has increased in recent years. However, research has found that there are some areas for concern:

  • Formal standards are lacking for care pathway development, implementation and evaluation. Transparency is also lacking for all of these areas.
  • Little is known about the true impact of pathways on patient outcomes and quality of care, or medical care resource use and cost of treatment.

Yet there also are promising trends in care pathway development and implementation. These include the prioritization of high-quality evidence considered in care pathway development, including key data sources such as treatment guidelines and randomized clinical trials. Researchers also found that there is flexibility in implementation by physicians to tailor treatment to their patients’ needs, most commonly through electronic medical record systems.

With these findings, researchers proposed four recommendations to improve current practices:

  • Develop consensus-driven best practices—Creating best practices to guide the development, implementation and evaluation of care pathways will help streamline an otherwise complicated process.
  • Create consistent methods for data collection and analysis—The ability to better collect and analyze data will support critical evaluation of care pathway performance against set goals.
  • Maintain transparency—All elements of pathway development, implementation and evaluation should be clear to providers and patients.
  • Provide patient access to disclosures—Patients should receive information about the development and impact of pathways, know whether treatment plans follow a care pathway and whether the clinical practice in which care is being delivered is subject to pathway-related incentives.