A clinical pathway is an evidence-based protocol for the treatment of disease. It considers the patient as a whole system and maps the entire journey through the health care process, rather than focusing on specific symptoms and issues. This approach to health care was introduced in both the United States and United Kingdom in the 1980s, and spread rapidly to other nations. Using clinical pathways can increase efficiency in the delivery of health care services and ensures that patients access appropriate treatment. Critics of this approach argue that it can make it more difficult to provide individualized care.
Numerous disciplines have developed clinical pathways for care providers to use. Each protocol includes an algorithm to be followed, starting with the initial condition and treatment options and moving through a series of steps. At each stage, there is a desired outcome the care provider can check for to determine if the patient is improving, and a next step to take. Time limitations are also structured into a clinical pathway to ensure that patients receive timely interventions.
One benefit to the use of a clinical pathway is standardized care, where all patients who present with a given problem get the same level of care. This can increase quality and reduce errors. It can also be more efficient, because it includes a clear structure that can be connected with the health care system to streamline services for the patient. The algorithm also makes it easier to measure patient outcomes, because they can be gauged against other patients who received the same care and compared to the progress expected with treatment.
Protocols can offer some protection from litigation by setting standards and practices for treatment that all care providers can follow. This can be a concern in some medical settings, where care providers may be worried about liability for the services they provide. Following protocols too closely, however, can create liability issues if the care provider ignores symptoms or doesn’t consider other factors in the case. Some room for personal judgment may be required in the use of a clinical pathway to ensure that problems aren’t missed in the desire to provide efficient care.
There are, however, a number of drawbacks to using a clinical pathway. These protocols work best for simple conditions without complications like co-morbidities. Recommendations for the treatment of one condition might interact badly with those for another. Patients with complex medical issues may need personalized care plans to receive the most appropriate treatment.