The reason of implementing care pathways (CPs) is to strengthen the quality of care by improving risk-adjusted patient outcomes, promoting patient safety, increasing patient satisfaction, and optimizing the use of resources. This has proved efficient not only for hospitals and clinics, but for patients too. CATCH ESR1 Ornela Bardhi

1. Clinical care pathways: A Review
Ornela Bardhi, M.Sc.
ESR1 – University of Deusto
Dr. Garcia-Zapirain; Ms. Daly; Mr. Nuño Solinís
This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the
Marie Sklodowska-Curie grant agreement number 722012
Introduction
The reason of implementing care pathways
(CPs) is to strengthen the quality of care by
improving risk-adjusted patient outcomes,
promoting patient safety, increasing patient
satisfaction, and optimizing the use of
resources. This has proved efficient not only
for hospitals and clinics, but for patients too.
Aim
A systematic literature review published from
2000 until February 2017 on cancer patient
care pathways, specifically on patient
experience and quality of life.
Materials and methods
A database search was performed with the
aim of detecting all published studies related
to CP for cancer patients, in which a
qualitative or quantitative analysis of the
outcome of the CP was done. The following
databases were searched: PubMed, Web of
Science and Science Direct. Figure 1 depicts
the search flowchart.
Fig 1: PRISMA flow diagram of the search
Conclusions
CP implementation has proved valuable
most of the time. Nevertheless, during
these studies the number of participants
was reduced towards the end of trials.
Reasons include complications and/or
having more than two comorbidities. In this
context, the main challenge is how to
implement CPs that are personalized to
patients’ needs.
Results
Implementation of cancer CPs have:
• Demonstrated improvements on
patients’ and healthcare personnel's
management [1], [2]
• Been cost-effective for hospitals and
patients [1], [2], [3]
• More satisfied and educated patients
[4], [5]
Some CPs include all perioperative
phases of cancer and the follow-up
period, but some may not include all the
pahses. Figure 2 shows distribution of
selected publications over the period 2000
and 2017 and Graph 1 the classification of
papers according to research method.
Fig 2: Number of publications on cancer patient CP from 2000-2017
References
[1] Chen et al., “The impact of clinical pathways
on the practice of head and neck oncology
surgery - The University of Texas M. D.
Anderson Cancer Center Experience”, JAMA
Otolaryngology-Head & Neck Surgery, 2000
[2] J.B.Y. So et al., “Reduced hospital stay after
implementation of a clinical pathway for radical
gastrectomy for gastric cancer”, Gastric Cancer,
2008
[3] S. Delaloge et al., “The challenge of rapid
diagnosis in oncology: Diagnostic accuracy and
cost analysis of a large-scale one-stop breast
clinic”, European Journal of Cancer, 2016
[4] M. Malmstrom et al., “Long-term
experiences after oesophagectomy/
gastrectomy for cancer — A focus group study”,
International Journal of Nursing Studies, 2012
[5] R.C. Numan et al., “A clinical audit in a
multidisciplinary care path for thoracic surgery:
An instrument for continuous quality
improvement”, Lung Cancer, 2012
Contact:
Email: ornela.bardhi@deusto.es
Twitter: @ornelabardhi
LinkedIn: linkedin.com/in/ornelabardhi
Website: www.catchitn.eu
• Papers published only in journals between
2000 and 2017 in English
• Papers describing the CP applied/used
• Papers describing the impact of the CP
• Before and after studies of CPs
• Trials of CPs
• Reviews of different CPs
• Papers evaluating the patient’s experience
before and after the CP implementation
and execution
Inclusion
criteria
• Papers analyzing cost and/or politics of the
CP
• Depression and anxiety CPs related to and
for cancer patients
• Papers published in Q4 journals or journals
without an impact factor
• Papers talking about how they came up with
the pathways and the meetings they needed
to hold, not about the pathway itself
• End-of-life CPs
• Letter to editor
Exclusion
criteria
0
5
10
15
20
25
30
35
Systematic
reviews
Mixed Descriptive Not defined Quantitative Qualitative Statistical
analysis
Nr.ofpublications
Research methodology
Graph 1. Classification of selected papers according research
methodology