Clinical pathway modelling: a literature review

Abstract

Hospital information systems are increasingly used as part of decision support tools for planning at strategic, tactical and operational decision levels. Clinical pathways are an effective and efficient approach in standardising the progression of treatment, to support patient care and facilitate clinical decision making. This literature review proposes a taxonomy of problems related to clinical pathways and explores the intersection between Information Systems (IS), Operational Research (OR) and industrial engineering. A structured search identified 175 papers included in the taxonomy and analysed in this review. The findings suggest that future work should consider industrial engineering integrated with OR techniques, with an aim to improving the handling of multiple scopes within one model, while encouraging interaction between the disjoint care levels and with a more direct focus on patient outcomes. Achieving this would continue to bridge the gap between OR, IS and industrial engineering, for clinical pathways to aid decision support.

A structured pathway for developing your complex abdominal hernia service: our York pathway

“…Structure, in the form of a pathway or guideline, improves patient outcomes and reduces cost [ 43 ]. Well designed pathways, which involve all the interested stakeholders in their design, help to assimilate clarity, continuity, competence and efficiency both for the patient and primary and secondary care [ 1 , 2 ]. They may streamline services by providing both physical and environmental organisations, ensuring that each individual patient has the right interventions performed at the right times by the right professionals [ 2 ].…”

“…Surgery is a high-risk speciality and inconsistencies in patient care and a lack of forward planning have potential disastrous effects [ 46 ]. Forward planning and a structured, evidence-based approach to CAWH patient care via a pathway may help [ 2 , 11 , 25 – 27 ]. Beyond this, well-organised pathways provide stability.…”

“…Providing structure breeds familiarity, repetition, excellence and a base line of what is expected for new staff. Such known patterns reduce uncertainty and improve productivity [ 2 ].…”

“…Clinical pathways may be associated with clinical efficacy and improved patient safety [ 1 ]. They are a method of “standardising the progression of treatment, to support patient care and facilitate clinical decision making” [ 2 ]. Clinical pathways streamline patient services in a health system that is overburdened and facing fiscal challenges [ 3 ].…”

Care Pathway And Prioritization Of Rapid Testing For Covid-19 In UK Hospitals: A Qualitative Evaluation

“…There is pressure to expedite test development and evaluation, and the demand on developing models to help identify optimal testing strategies is also high. Patient care pathway analysis [7] is the rst step in that direction, [8] supporting the identi cation of the most effective role of new tests in the current care pathway.…”