Integrated care pathways in neurosurgery: A systematic review.

Area of Science:

• Neurosurgery
• Healthcare Management
• Evidence-Based Practice

Background:

• Integrated care pathways (ICPs) are structured multidisciplinary frameworks designed to enhance patient care.
• They offer potential benefits including improved continuity, safety, satisfaction, efficiency, teamwork, and staff education.

Purpose of the Study:

• To systematically review existing neurosurgical ICPs.
• To identify their impact and design features associated with success.
• To inform future development of neurosurgical ICPs.

Main Methods:

• Systematic literature search of MEDLINE, EMBASE, and CENTRAL up to July 2020.
• Inclusion of primary studies detailing neurosurgical ICPs across all pathologies and age groups.
• Recording of patient outcomes and evaluation metrics.

Main Results:

• Twenty-four studies from diverse international centers and neurosurgical sub-specialties were included.
• Effectiveness was primarily measured by length of stay and adverse events; patient-reported outcomes were infrequent.
• All included studies reported positive impacts of ICPs.

Conclusions:

• Neurosurgical ICPs have been successfully implemented across various sub-specialties.
• There is a need for greater clarity in ICP design and evaluation methodologies.
• The patient's perspective is underrepresented in current evaluations.