Clinical pathways--the new paradigm in healthcare?

A clinical pathway defines the optimal care process, sequencing and timing of interventions by doctors, nurses and other healthcare professionals for a particular diagnosis or procedure. It is a relatively new clinical process improvement tool that has been gaining popularity across hospitals in the USA, Australia and United Kingdom. Clinical pathways are developed through collaborative efforts of clinicians, nurses, pharmacists, physiotherapists and other allied healthcare professionals with the aim towards improving the quality of patient care. Clinical pathways have been shown to reduce unnecessary variation in patient care, reduce delays in discharge through more efficient discharge planning, and improve the cost-effectiveness of clinical services. The approach and objectives of clinical pathways are consistent with those of total quality management (TQM) and continuous quality improvement (CQI) and is essentially the application of these principles to the patient's bedside. This article examines the proliferation in the use of clinical pathways, its benefits to the healthcare organisation, its application as a tool for CQI activities in direct relation to patient care and the medico-legal implications involved.