Insight into how clinical pathways are used and viewed by physicians can help to optimize hospital improvement work and enhance high-value care (Pediatr Qual Saf. 2020;5[2]:e270. doi:10.1097/pq9.0000000000000270).
“Healthcare costs are rising, and clinical pathways are one means to promote high-value care by standardizing care and improving outcomes without compromising cost or quality. However, providers do not always follow [clinical pathways], and our understanding of their perceptions is limited,” wrote Kimberly O’Hara, MD, Department of Pediatrics, University of Colorado School of Medicine, Aurora, and colleagues.
This study aimed to examine pediatric hospital medicine and emergency medicine physician perspectives of clinical pathways.
One-on-one qualitative interviews were conducted with 15 pediatric hospital medicine physicians and 15 pediatric emergency medicine physicians between February 2017 and August 2017. The interviews were analyzed to identify themes.
The perceived benefits of clinical pathways included reduction of unnecessary utilization, standardization of care, improved communication, education of oneself and others, and confidence and validation when actions align with clinical pathways.
Limitations of clinical pathways were resource utilization for revisions, updates, and dissemination, “tunnel vision” and cognitive biases, loss of autonomy, prescriptive medicine, information overload, pressure to adhere, and guilt if actions do not align with clinical pathways.
“Physicians view [clinical pathways] differently, and thus, how they implement these tools in clinical practice varies. Such insight into how physicians perceive [clinical pathways] may help to optimize hospital systems improvement work, reduce healthcare waste, and provide high-quality care,” concluded Dr O’Hara and colleagues.—Lisa Kuhns
