Evidence-based practice needs evidence-based implementation.
Clinical pathways have been designed to provide an effective interface between evidence and practice in healthcare. Strong evidence supports the assertion that when clinical pathways are utilized they improve outcomes. However, published evidence measuring the uptake of clinical pathways by health professionals remains sparse. This article presents a study evaluating the degree of documented compliance with the clinical pathway chart used for patients diagnosed with an acute myocardial infarction (AMI) in a major Australian regional hospital. The relationships between compliance and demographic and illness were also examined. Data were collected from 124 records with the result that the level of documented compliance was 16.5%. Clients with private health insurance had significantly higher documented compliance with the clinical pathway than those with no private health insurance. There were also significant variations in documented compliance according to the type of AMI recorded. Recommendations to improve compliance with clinical pathways are included along with recommendations for future research.
Kinsman
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School of Health and Environment, LaTrobe University, Bendigo, P.O. Box 199, Bendigo, Victoria, Australia 3552. l.kinsman@bendigo.latrobe.edu.au
James
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019091:Critical Pathways / Q000706:statistics & numerical data*; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D017749:Total Quality Management / Q000458:organization & administration; D014739:Victoria