A framework for clinical care pathway renewal: an example from inflammatory bowel disease

Area of Science:

• Healthcare Management
• Clinical Practice Guidelines
• Evidence-Based Medicine

Background:

• Clinical care pathways (CCPs) standardize care but require regular updates to reflect current evidence.
• Existing literature lacks guidance on the renewal process for CCPs as new evidence emerges.
• Updating CCPs is crucial for maintaining high-quality, evidence-based healthcare delivery.

Purpose of the Study:

• To develop a recurrent framework for the renewal of clinical care pathways (CCPs).
• To apply the developed framework to existing provincial CCPs for inflammatory bowel disease (IBD).
• To standardize the process of updating and renewing healthcare clinical pathways.

Main Methods:

• A review matrix was developed, stratified by risk to change and clinical impact of CCPs.
• A multidisciplinary workshop engaged 22 IBD stakeholders to refine and apply the framework.
• Attendees provided feedback and voted on matrix definitions, then applied the framework to existing IBD CCPs.

Main Results:

• A four-level review matrix was agreed upon, categorizing CCPs by risk to change and clinical impact.
• Risk to change was defined by the speed of evidence evolution, and clinical impact by importance to quality care.
• Stakeholders reached consensus on assigning levels to existing IBD CCPs using the framework.

Conclusions:

• The developed framework provides a standardized approach to updating and renewing clinical pathways.
• Utilizing this framework ensures CCPs remain current, aiding healthcare professionals in clinical decision-making.
• The framework is adaptable across healthcare disciplines to establish a robust renewal process.