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Related Experiment Video

Updated: Aug 2, 2025

Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
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Symptom management care pathway adaptation process and specific adaptation decisions.

Emily Vettese1, Farha Sherani2,3, Allison A King4

  • 1Program in Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.

BMC Cancer
|April 18, 2023
PubMed
Summary

Pediatric cancer symptom management care pathways were adapted by institutions, with most statements adopted or modified. This process was efficient, taking a median of 4.2 weeks, and institutional factors did not influence statement rejection.

Keywords:
Care pathwayClinical practice guidelinesImplementationOncologyPediatricSupportive careSymptom management

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Area of Science:

  • Oncology
  • Clinical Practice Guidelines
  • Healthcare Management

Background:

  • Significant variability exists in symptom management for pediatric cancer patients.
  • Clinical practice guidelines aim to standardize care but require adaptation.
  • Understanding the adaptation process is crucial for guideline implementation.

Purpose of the Study:

  • To describe the adaptation process of symptom management care pathways based on clinical practice guidelines.
  • To identify specific adaptation decisions made during pathway development.
  • To evaluate the association between institutional factors and adaptation decisions.

Main Methods:

  • Fourteen care pathway templates were reviewed by 10 institutions' adaptation teams.
  • Clinician teams decided to adopt, adapt, or reject each statement within the templates.
  • Feedback from broader institutional teams led to modifications of the drafted pathways.

Main Results:

  • Adaptation decisions for care pathways were completed in a median of 4.2 weeks per institution.
  • Out of 1350 statements, 40.8% were adopted and 48.7% were adapted.
  • The primary reason for rejecting statements was disagreement (81.4%), with no significant association with institutional factors.

Conclusions:

  • The high adoption/adaptation rate indicates the acceptability of the care pathways.
  • The adaptation process was completed efficiently within a short timeframe.
  • Future research should assess compliance and the impact of pathway-consistent care on patient outcomes.