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Current Reasons for Not Using Clinical Pathways in Practice.

Murat Sariyar1, Thomas Bürkle1, Michael Lehmann1

  • 1Bern University of Applied Sciences, Biel, Switzerland.

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Most Swiss hospitals struggle to implement clinical pathways, which are documents guiding multidisciplinary patient treatment. This study explores organizational, environmental, and pathway-specific barriers hindering widespread adoption in healthcare settings.

Keywords:
Clinical pathwayguidelinesprocess-orientation

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Area of Science:

  • Healthcare Management
  • Health Services Research

Background:

  • Clinical pathways are widely promoted for efficient healthcare delivery.
  • However, their actual implementation in Swiss hospitals remains limited.
  • The 'Hospital of the Future' project provided insights into these challenges.

Purpose of the Study:

  • To investigate the reasons behind the low implementation rates of clinical pathways in Swiss hospitals.
  • To identify and categorize the barriers hindering effective pathway adoption.
  • To inform policy and regulation for future healthcare improvements.

Main Methods:

  • Qualitative analysis of experiences from the Swiss research project 'Hospital of the Future'.
  • Categorization of implementation impediments into organization-specific, environmental, and pathway-inherent factors.
  • Discussion of policy implications for healthcare management.

Main Results:

  • Most Swiss hospitals do not implement clinical pathways as defined (multidisciplinary treatment documents).
  • Key barriers include organization-specific impediments, external environmental hurdles, and inherent issues with the pathways themselves.
  • Lack of policy support and regulation is a significant factor.

Conclusions:

  • Widespread adoption of clinical pathways in Switzerland is unlikely without policy intervention.
  • Addressing organizational, environmental, and pathway-specific challenges is crucial.
  • Policy maker support and regulation are essential for successful healthcare pathway implementation.