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as expected. In this way results are recorded, and important questions and actions are not overlooked. However, pathways are typically not prescriptive; the patient's journey is an individual one, and an important part of the purpose of the pathway documents is to capture information on "variances", where due to circumstances or clinical judgment different actions have been taken, or different results unfolded. The combined variances for a sufficiently large population of patients are then analysed to identify important or systematic features, which can be used to improve the next iteration of the pathway.
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The pathway design tries to capture the foreseeable actions which will most commonly represent best practice for most patients most of the time, and include prompts for them at the appropriate time in the pathway document to ascertain whether they have been carried out, and whether results have been
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often view clinical pathways in a similar way as they view care plans, in which the care provided to a patient is definitive and deliberate. Clinical pathways can range in scope from simple medication utilization to a comprehensive treatment plan. Clinical pathways aim for greater standardization of
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More than just a guideline or a protocol, a care pathway is typically recorded in a single all-encompassing bedside document that will stand as an indicator of the care a patient is likely to be provided in the course of the pathway going forward; and ultimately as a single unified legal record of
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management tool based on evidence-based practice for a specific group of patients with a predictable clinical course, in which the different tasks (interventions) by the professionals involved in the patient care are defined, optimized and sequenced either by hour (ED), day (acute care) or visit
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Deneckere, Svin; Euwema, Martin; Lodewijckx, Cathy; Panella, Massimiliano; Mutsvari, Timothy; Sermeus, Walter; Vanhaecht, Kris (January 2013). "Better interprofessional teamwork, higher level of organized care, and lower risk of burnout in acute health care teams using care pathways: a cluster
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Rotter, Thomas; Kinsman, Leigh; James, Erica; Machotta, Andreas; Willis, Jon; Snow, Pamela; Kugler, Joachim (March 2012). "The effects of clinical pathways on professional practice, patient outcomes, length of stay, and hospital costs: Cochrane systematic review and meta-analysis".
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thinking to the improvement of patient healthcare. An aim is to re-center the focus on the patient's overall journey, rather than the contribution of each specialty or caring function independently. Instead, all are emphasised to be working together, in the same way as a
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Rotter, Thomas; Kinsman, Leigh; James, Erica; Machotta, Andreas; Gothe, Holger; Willis, Jon; Snow, Pamela; Kugler, Joachim (March 2010). "Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costs".
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Vanhaecht, Kris; Ovretveit, John; Elliott, Martin J.; Sermeus, Walter; Ellershaw, John; Panella, Massimiliano (March 2012). "Have we drawn the wrong conclusions about the value of care pathways? Is a
Cochrane review appropriate?".
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Faber, Marjan J; Grande, Stuart; Wollersheim, Hub; Hermens, Rosella; Elwyn, Glyn (June 2014). "Narrowing the gap between organisational demands and the quest for patient involvement: the case for coordinated care pathways".
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Deneckere, Svin; Euwema, Martin; Van Herck, Pieter; Lodewijckx, Cathy; Panella, Massimiliano; Sermeus, Walter; Vanhaecht, Kris (July 2012). "Care pathways lead to better teamwork: results of a systematic review".
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Vanhaecht, Kris; Panella, Massimiliano; Van Zelm, Ruben; Sermeus, Walter (September 2010). "An overview on the history and concept of care pathways as complex interventions".
198:, United States) in 1985, inspired by Karen Zander and Kathleen Bower. Clinical pathways appeared as a result of the adaptation of the documents used in industrial
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Vanhaecht, Kris; Panella, Massimiliano; Van Zelm, Ruben; Sermeus, Walter (November 2009). "Is there a future for pathways? Five pieces of the puzzle".
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The following signals may indicate that it may be useful to commit resources to establish and implement a clinical pathway for a particular condition:
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Mould, Gillian; Bowers, John (September 2011). "Roles of pathway-based models and their contribution to the redesign of health-care systems".
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1054:"Care pathways across the primary-hospital care continuum: using the multi-level framework in explaining care coordination"
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concerning the standardisation of care processes. It has been shown that their implementation reduces the variability in
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Weber, Philip; Filho, João Bosco
Ferreira; Bordbar, Behzad; Lee, Mark; Litchfield, Ian; Backman, Ruth (October 2017).
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Maturen, Virginia; Van Dyck, Lisa (February 1996). "Using outcome-based critical pathways to improve documentation".
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1359:"International Journal of Care Coordination (formerly published as the International Journal of Care Pathways)"
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the care the patient has received, and the progress of their condition, as the pathway has been undertaken.
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Smith, Shawn R. (June 2017). "Enlisting patient and family advisers in the design of clinical pathways".
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Bower, Kathleen A. (November 2009). "Clinical pathways: 12 lessons learned over 25 years of experience".
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Improving healthcare operations: the application of lean, agile, and leagility in care pathway design
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Van Houdt, Sabine; Heyrman, Jan; Vanhaecht, Kris; Sermeus, Walter; De
Lepeleire, Jan (August 2013).
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Huang, Zhengxing; Dong, Wei; Ji, Lei; Gan, Chenxi; Lu, Xudong; Duan, Huilong (February 2014).
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954:"Mining and exploring care pathways from electronic medical records with visual analytics"
849:"Discovery of clinical pathway patterns from event logs using probabilistic topic models"
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Panella, Massimiliano; Van Zelm, Ruben; Sermeus, Walter; Vanhaecht, Kris (January 2012).
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The concept of clinical pathways may have different meanings to different stakeholders.
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Allen, Davina (March 2010). "Care pathways: an ethnographic description of the field".
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1030:"On the right track? How HealthPathways are improving care in Canterbury, New Zealand"
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Evans-Lacko, Sara; Jarrett, Manuela; McCrone, Paul; Thornicroft, Graham (June 2010).
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Kinsman, Leigh; Rotter, Thomas; James, Erica; Snow, Pamela; Willis, Jon (May 2010).
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Panella, Massimiliano; Marchisio, Sara; Di
Stanislao, Francesco (December 2003).
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and improves outcomes. Clinical pathways aim to promote organised and efficient
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Clinical pathways (integrated care pathways) can be seen as an application of
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treatment regimens and sequencing as well as improved outcomes, from both a
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Zander, Karen S.; Bower, Kathleen A.; Etheredge, Mary Lou S. (1987) .
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Changing clinical care: experiences and lessons of systematisation
745:"Facilitators and barriers to implementing clinical care pathways"
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Existence of recommendations of good practices or experts opinions
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Gray, Andrew; Degeling, Pieter; Colebatch, Hal K., eds. (2008).
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The clinical pathway concept appeared for the first time at the
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Bulletin: Economics, Organisation and
Informatics in Healthcare
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1199:"Automated conflict detection between medical care pathways"
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Motivation by professionals to work on a specific condition
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166:(homecare). Outcomes are tied to specific interventions.
125:, is one of the main tools used to manage the quality in
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Pathology well defined and that permits homogeneous care
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Nursing case management: blueprints for transformation
395:"Care pathways for the organization of patients' care"
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Perer, Adam; Wang, Fei; Hu, Jianying (August 2015).
141:, and aim to optimise outcomes in settings such as
149:. A single clinical pathway may refer to multiple
661:. Boston: New England Medical Center Hospitals.
432:International Journal for Quality in Health Care
272:Possibility of obtaining professional agreement
153:on several topics in a well specified context.
254:Pathology with a significant risk for patients
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289:Liverpool Care Pathway for the Dying Patient
471:The Cochrane Database of Systematic Reviews
257:Pathology with a high cost for the hospital
251:Prevalent pathology within the care setting
210:Improve efficiency in the use of resources.
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93:Learn how and when to remove this message
633:"What do clinical pathways mean to you?"
56:This article includes a list of general
27:Systemised approach to medical treatment
1321:"HealthPathways Community, New Zealand"
1103:Evaluation & the Health Professions
1028:Timmins, Nicholas (14 September 2013).
505:Evaluation & the Health Professions
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1170:International Journal of Care Pathways
1141:International Journal of Care Pathways
915:International Journal of Care Pathways
716:International Journal of Care Pathways
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886:Journal of Home Health Care Practice
62:it lacks sufficient corresponding
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959:Journal of Biomedical Informatics
854:Journal of Biomedical Informatics
992:Journal of Healthcare Management
275:Multidisciplinary implementation
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824:. Oxford; New York: Radcliffe.
631:Wong, Winston (1 August 2015).
564:10.1016/j.socscimed.2012.02.060
269:Unexplained variability of care
1340:"Journal of Clinical Pathways"
1302:"European Pathway Association"
586:randomized controlled trial".
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637:journalofclinicalpathways.com
551:Social Science & Medicine
204:standard operating procedures
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1283:"Clinical Pathways Congress"
1235:Williams, Sharon J. (2017).
1059:BMC Health Services Research
750:BMC Health Services Research
602:10.1097/MLR.0b013e3182763312
306:European Pathway Association
1325:healthpathwayscommunity.org
260:Predictable clinical course
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213:Finish work in a set time.
192:New England Medical Center
171:Managed care organizations
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206:(SOPs), whose goals are:
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728:10.1258/jicp.2009.009008
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161:A clinical pathway is a
30:Not to be confused with
316:Medical case management
139:evidence-based medicine
115:integrated care pathway
77:more precise citations.
1398:Health care management
1005:10.1097/JHM-D-17-00045
361:10.1186/1741-7015-8-31
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301:Clinical formulation
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243:Selection criteria
224:process management
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321:Nursing care plan
180:clinical outcomes
163:multidisciplinary
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75:introducing
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1368:12 October
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693:(1): 4–9.
327:References
157:Definition
143:acute care
127:healthcare
58:references
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