[From clinical guidelines to clinical pathways: development of a management-oriented algorithm for the treatment of polytraumatized patients in the acute period].
BACKGROUND
The treatment of polytraumatized patients in the acute period is an exemplary model of multidisciplinary cooperation in a very critical timeframe. Implementing standards formulated in the clinical guidelines of the German Association of Traumatology requires a detailed description of "how to do it."


METHODS
Based on the guidelines and validated quality indictors, the optimal standard of care as the goal was defined. A clinical algorithm was developed and personal responsibilities and time limits were clearly assigned to each decision step and action. Checklists, documentation charts, and a full text supplement the algorithm. The complete pathway was adopted by representatives of all occupational groups involved in early trauma care in a consensus process.


RESULTS
Improvement potentials were identified in those areas for which the guidelines did not provide explicit recommendations. These represent the key elements of the algorithm. Pathway-specific review criteria (quality indicators) were defined for scheduled reevaluation.


CONCLUSIONS
Implementing clinical guidelines at the local level requires a problem-oriented and management-oriented elaboration towards a clinical pathway as the basis for a quantitative process and cost analysis.
Schnabel
M
M
Klinik für Unfall-, Wiederherstellungs- und Handchirurgie, Klinikum der Philipps-Universität Marburg. schnabem@mailer.uni-marburg.de
Kill
C
C
El-Sheik
M
M
Sauvageot
A
A
Klose
K J
KJ
Kopp
I
I
D000465:Algorithms; D005260:Female; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000628:therapy*; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care