Clinical pathway audit tools: a systematic review.
OBJECTIVE
To determine whether clinical/care pathway audit tools can identify the characteristics of well-organized care processes.


BACKGROUND
Although pathways are used worldwide, confusion exists about the concept and impact. Evaluation Search of OVID-Medline, Cinahl, British Nursing Index; manual search of the Journal of Integrated Care Pathways; contact with Smartgroup on Clinical Pathways and board members of the European Pathway Association and Google search.


RESULTS
We selected seven of 15 clinical pathway audit tools for this review. Through content analysis, we identified 17 characteristics and grouped them using the realistic evaluation paradigm. The Integrated Care Pathway Appraisal Tool is the most appropriate audit tool to assess clinical pathway documents.


CONCLUSIONS
It is astonishing that so little research on clinical pathway audit tools has been underwent, given the prevalent use of clinical pathways. Because the concept of clinical pathways remains unclear, a variety of audit tools are needed to help clarify the concept. Further research on the construct and criterion validity of pathway audit tools is necessary to fully understand why and under which circumstances pathways lead to improved care.
Vanhaecht
Kris
K
Centre for Health Services and Nursing Research, School of Public Health, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium. kris.vanhaecht@med.kuleuven.be
De Witte
Karel
K
Depreitere
Roeland
R
Sermeus
Walter
W
D019091:Critical Pathways / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D006801:Humans; D008330:Management Audit / Q000379:methods*; D015397:Program Evaluation; D019984:Quality Indicators, Health Care; D015203:Reproducibility of Results