Critical pathway: Difference between revisions

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In [[health care]], '''critical pathways''' are "schedules of medical and nursing procedures, including diagnostic tests, medications, and consultations designed to effect an efficient, coordinated program of treatment."<ref>{{MeSH}}</ref><ref name="pmid10691588">{{cite journal| author=Morris AH| title=Developing and implementing computerized protocols for standardization of clinical decisions. | journal=Ann Intern Med | year= 2000 | volume= 132 | issue= 5 | pages= 373-83 | pmid=10691588  
In [[health care]], '''critical pathways''' are "schedules of medical and nursing procedures, including diagnostic tests, medications, and consultations designed to effect an efficient, coordinated program of treatment."<ref>{{MeSH}}</ref><ref name="pmid10691588">{{cite journal| author=Morris AH| title=Developing and implementing computerized protocols for standardization of clinical decisions. | journal=Ann Intern Med | year= 2000 | volume= 132 | issue= 5 | pages= 373-83 | pmid=10691588  
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=10691588 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref><ref name="pmid7486490">{{cite journal| author=Pearson SD, Goulart-Fisher D, Lee TH| title=Critical pathways as a strategy for improving care: problems and potential. | journal=Ann Intern Med | year= 1995 | volume= 123 | issue= 12 | pages= 941-8 | pmid=7486490  
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=10691588 }}</ref><ref name="pmid7486490">{{cite journal| author=Pearson SD, Goulart-Fisher D, Lee TH| title=Critical pathways as a strategy for improving care: problems and potential. | journal=Ann Intern Med | year= 1995 | volume= 123 | issue= 12 | pages= 941-8 | pmid=7486490  
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=7486490 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref>
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=7486490 }}</ref>


==Effectiveness==
==Effectiveness==
A critical pathway may improve the outcomes of [[pneumonia]]<ref name="pmid10683053">{{cite journal |author=Marrie TJ, Lau CY, Wheeler SL, Wong CJ, Vandervoort MK, Feagan BG |title=A controlled trial of a critical pathway for treatment of community-acquired pneumonia. CAPITAL Study Investigators. Community-Acquired Pneumonia Intervention Trial Assessing Levofloxacin |journal=JAMA |volume=283 |issue=6 |pages=749-55 |year=2000 |pmid=10683053 |doi=}}</ref>, chest pain<ref name="pmid12117399">{{cite journal| author=Reilly BM, Evans AT, Schaider JJ, Das K, Calvin JE, Moran LA et al.| title=Impact of a clinical decision rule on hospital triage of patients with suspected acute cardiac ischemia in the emergency department. | journal=JAMA | year= 2002 | volume= 288 | issue= 3 | pages= 342-50 | pmid=12117399  
"Clinical pathways are associated with reduced in-hospital complications and improved documentation without negatively impacting on length of stay and hospital costs." according to a [[meta-analysis]] by the [[Cochrane Collaboration]].<ref name="pmid20238347">{{cite journal| author=Rotter T, Kinsman L, James E, Machotta A, Gothe H, Willis J et al.| title=Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costs. | journal=Cochrane Database Syst Rev | year= 2010 | volume=  | issue= 3 | pages= CD006632 | pmid=20238347 | doi=10.1002/14651858.CD006632.pub2 | pmc= | url= }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20713779 Review in: Ann Intern Med. 2010 Aug 17;153(4):JC2-12] </ref>
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=12117399 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref><ref name="pmid9412306">{{cite journal| author=Nichol G, Walls R, Goldman L, Pearson S, Hartley LH, Antman E et al.| title=A critical pathway for management of patients with acute chest pain who are at low risk for myocardial ischemia: recommendations and potential impact. | journal=Ann Intern Med | year= 1997 | volume= 127 | issue= 11 | pages= 996-1005 | pmid=9412306  
 
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=9412306 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref>, and maybe [[stroke]]<ref name="pmid15495038">{{cite journal| author=Kwan J, Sandercock P| title=In-hospital care pathways for stroke. | journal=Cochrane Database Syst Rev | year= 2004 | volume=  | issue= 4 | pages= CD002924 | pmid=15495038  
As examples, a critical pathway may improve the outcomes of [[pneumonia]]<ref name="pmid10683053">{{cite journal |author=Marrie TJ, Lau CY, Wheeler SL, Wong CJ, Vandervoort MK, Feagan BG |title=A controlled trial of a critical pathway for treatment of community-acquired pneumonia. CAPITAL Study Investigators. Community-Acquired Pneumonia Intervention Trial Assessing Levofloxacin |journal=JAMA |volume=283 |issue=6 |pages=749-55 |year=2000 |pmid=10683053 |doi=}}</ref>, chest pain<ref name="pmid12117399">{{cite journal| author=Reilly BM, Evans AT, Schaider JJ, Das K, Calvin JE, Moran LA et al.| title=Impact of a clinical decision rule on hospital triage of patients with suspected acute cardiac ischemia in the emergency department. | journal=JAMA | year= 2002 | volume= 288 | issue= 3 | pages= 342-50 | pmid=12117399  
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=15495038 | doi=10.1002/14651858.CD002924.pub2 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref>.
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=12117399 }}</ref><ref name="pmid9412306">{{cite journal| author=Nichol G, Walls R, Goldman L, Pearson S, Hartley LH, Antman E et al.| title=A critical pathway for management of patients with acute chest pain who are at low risk for myocardial ischemia: recommendations and potential impact. | journal=Ann Intern Med | year= 1997 | volume= 127 | issue= 11 | pages= 996-1005 | pmid=9412306  
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=9412306 }}</ref>, and maybe [[stroke]]<ref name="pmid15495038">{{cite journal| author=Kwan J, Sandercock P| title=In-hospital care pathways for stroke. | journal=Cochrane Database Syst Rev | year= 2004 | volume=  | issue= 4 | pages= CD002924 | pmid=15495038  
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=15495038 | doi=10.1002/14651858.CD002924.pub2 }} </ref>.


==References==
==References==
<references/>
<references/>

Revision as of 11:37, 7 April 2011

In health care, critical pathways are "schedules of medical and nursing procedures, including diagnostic tests, medications, and consultations designed to effect an efficient, coordinated program of treatment."[1][2][3]

Effectiveness

"Clinical pathways are associated with reduced in-hospital complications and improved documentation without negatively impacting on length of stay and hospital costs." according to a meta-analysis by the Cochrane Collaboration.[4]

As examples, a critical pathway may improve the outcomes of pneumonia[5], chest pain[6][7], and maybe stroke[8].

References

  1. Anonymous (2024), Critical pathway (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Morris AH (2000). "Developing and implementing computerized protocols for standardization of clinical decisions.". Ann Intern Med 132 (5): 373-83. PMID 10691588.
  3. Pearson SD, Goulart-Fisher D, Lee TH (1995). "Critical pathways as a strategy for improving care: problems and potential.". Ann Intern Med 123 (12): 941-8. PMID 7486490.
  4. Rotter T, Kinsman L, James E, Machotta A, Gothe H, Willis J et al. (2010). "Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costs.". Cochrane Database Syst Rev (3): CD006632. DOI:10.1002/14651858.CD006632.pub2. PMID 20238347. Research Blogging. Review in: Ann Intern Med. 2010 Aug 17;153(4):JC2-12
  5. Marrie TJ, Lau CY, Wheeler SL, Wong CJ, Vandervoort MK, Feagan BG (2000). "A controlled trial of a critical pathway for treatment of community-acquired pneumonia. CAPITAL Study Investigators. Community-Acquired Pneumonia Intervention Trial Assessing Levofloxacin". JAMA 283 (6): 749-55. PMID 10683053[e]
  6. Reilly BM, Evans AT, Schaider JJ, Das K, Calvin JE, Moran LA et al. (2002). "Impact of a clinical decision rule on hospital triage of patients with suspected acute cardiac ischemia in the emergency department.". JAMA 288 (3): 342-50. PMID 12117399.
  7. Nichol G, Walls R, Goldman L, Pearson S, Hartley LH, Antman E et al. (1997). "A critical pathway for management of patients with acute chest pain who are at low risk for myocardial ischemia: recommendations and potential impact.". Ann Intern Med 127 (11): 996-1005. PMID 9412306.
  8. Kwan J, Sandercock P (2004). "In-hospital care pathways for stroke.". Cochrane Database Syst Rev (4): CD002924. DOI:10.1002/14651858.CD002924.pub2. PMID 15495038. Research Blogging.