Barriers to Successful Implementation of a Clinical Pathway for CHF

Abstract

Clinical pathways represent a strategy for responding to the current healthcare environment with a focus on managing care, reducing costs, increasing patient satisfaction, and improving quality. However, many healthcare organizations have found that implementing clinical pathways is not entirely successful even when they are based on sound evidence. The purpose of this case study was to describe and explain factors related to the success or failure of implementing a clinical pathway for congestive heart failure (CHF) patients in a 300-bed community hospital. The key factors involved in the nonadoption of the CHF pathway were inconsistencies in procedures and the work group culture.

Clinical pathways in 17 European Union countries: a purposive survey

“…For example, Pace et al reported a study that showed the main barriers were clinical practice variation among doctors and poor attitudes towards teamwork. 16 There is little literature on the use of clinical pathways for service planning or for crosssetting care, nor are there adequate global statistics on the degree of use of pathways. Moreover, the literature is not evenly balanced in providing the experiences in smaller countries that do not use one of the major international languages.…”

Nurses' perceptions of working according to standardized care plans: a questionnaire study

“…A majority experienced they were not involved in the development of the SCP. The introduction of new guidelines and SCPs is a complex process dependent on many factors such as context and leadership as described in several studies (15)(16)(17)19). How the implementation process was actually performed at the different clinics was, however, not studied in the present study.…”

What competencies are needed by operational managers in managing care pathways?

“…Coaching, external orientation, verbal skills and self-knowledge Pace et al 21 Connecting culture and innovation by adjusting the perception. Interactive learning ability and tactical behaviour/adaptability Gibbon et al 15 Creating a climate which contributes to a sense of safety of the team members, in order to stimulate participation in decision-making.…”