title: Variation in 17 obstetric care pathways: potential danger for health professionals and patient safety?
abstract: OBJECTIVE
  To report a study to determine whether or not variations exist in evidence-based key interventions in pathway documents for normal delivery across hospitals.
  
  
  BACKGROUND
  Care pathways are used worldwide to standardize and follow up patient-focused care. Minimal variations in pathway documents increase standardization and patient safety.
  
  
  METHODS
  A descriptive study design using qualitative methods was used, to examine the various key interventions present in care pathway documents for normal delivery.
  
  
  METHODS
  Between January-March 2009, we evaluated the content of the care pathway document for normal delivery from 17 different hospitals. The key interventions in these pathways were compared with the 40 evidence-based key interventions of Map of Medicine®.
  
  
  RESULTS
  There was much variation in the characteristics and the presence of key interventions in the pathway documents. Only 6 of the 40 evidence-based key interventions (15%) were found in all 17 pathway documents and 20 of the 40 interventions (50%) were found in only 10 pathway documents.
  
  
  CONCLUSIONS
  If variation already exists among the care pathway documents, this may lead to a high probability of variation in the actual performance of daily care. In this study is shown that, even for highly predictable medical conditions, there are huge differences in the evidence-based content and structure of pathways. Lack of evidence base could potentially endanger both patient safety and the health professional.
authors.affiliation: Department of Women and Child, University Hospitals Leuven, Belgium.
authors.forename: Mirella
authors.initials: M
authors.lastname: Sarrechia
authors.forename: Eva
authors.initials: E
authors.lastname: Van Gerven
authors.forename: Lien
authors.initials: L
authors.lastname: Hermans
authors.forename: Svin
authors.initials: S
authors.lastname: Deneckere
authors.forename: Walter
authors.initials: W
authors.lastname: Sermeus
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Panella
authors.forename: Bernard
authors.initials: B
authors.lastname: Spitz
authors.forename: Kris
authors.initials: K
authors.lastname: Vanhaecht
mesh_terms: D019091:Critical Pathways / Q000592:standards*; D036861:Delivery, Obstetric / Q000451:nursing* / Q000592:standards; D004282:Documentation / Q000592:standards; D055318:Evidence-Based Nursing; D005260:Female; D006801:Humans; D061214:Patient Safety / Q000592:standards*; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D011364:Professional Practice / Q000592:standards