title: The importance of clinical pathways and protocols in pediatric nephrology.
abstract: Modern clinical practice is increasingly delivered by teams of individuals working within an environment of rising complexity and daunting patient care loads. Clinical pathways, protocols and checklists offer a way to assure coordination, efficiency, quality and safety in this chaotic environment. In this review, we discuss some of the principal characteristics of these clinical tools, some of the challenges involved with introducing them into clinical practice and the evidence that they can positively affect patient and system outcomes. We believe pediatric nephrology, as a discipline, is ready for the widespread introduction of these important quality tools.
authors: Division of Nephrology, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada, cmammen@cw.bc.ca.
authors: Cherry
authors: C
authors: Mammen
authors: Douglas G
authors: DG
authors: Matsell
authors: Kevin V
authors: KV
authors: Lemley
mesh_terms: D002648:Child; D002985:Clinical Protocols / Q000592:standards*; D019091:Critical Pathways / Q000592:standards*; D006801:Humans; D009398:Nephrology / Q000592:standards*; D010372:Pediatrics / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000592:standards*
references: Harv Bus Rev. 2010 Apr;88(4):62-9
references: 20402057
references: N Engl J Med. 2009 Jan 29;360(5):491-9
references: 19144931
references: Health Aff (Millwood). 2012 Jan;31(1):220-7
references: 22155485
references: J Am Board Fam Med. 2012 Jan-Feb;25(1):83-6
references: 22218628
references: BMJ. 1998 Jan 10;316(7125):133-7
references: 9462322
references: Nephrol Dial Transplant. 2008 Jul;23(7):2162-6
references: 18469309
references: Qual Manag Health Care. 1995 Winter;3(2):14-29
references: 10141770
references: Med J Aust. 2004 Oct 18;181(8):428-31
references: 15487958
references: J Nurs Manag. 2006 Oct;14(7):503-5
references: 17004959
references: Eval Health Prof. 2012 Mar;35(1):3-27
references: 21613244
references: Am J Manag Care. 2003 Nov;9(11):758-65
references: 14626473
references: N Engl J Med. 2010 Dec 23;363(26):2530-9
references: 21175315
references: N Engl J Med. 2012 Mar 1;366(9):777-9
references: 22375966
references: CMAJ. 1997 Jun 15;156(12):1725-7
references: 9220924
references: JAMA. 2008 Mar 12;299(10):1182-4
references: 18334694
references: N Engl J Med. 1993 Oct 21;329(17):1271-3
references: 8413397
references: Langenbecks Arch Surg. 2010 Jan;395(1):11-7
references: 19763604
references: J Nurs Manag. 2006 Oct;14(7):529-37
references: 17004963
references: BMJ. 2008 Oct 06;337:a1714
references: 18838424
references: J Nurs Manag. 2006 Oct;14(7):553-63
references: 17004966
references: Qual Manag Health Care. 1992 Fall;1(1):45-54
references: 10131646
references: Health Aff (Millwood). 2011 Jun;30(6):1185-91
references: 21596758
references: Health Aff (Millwood). 2011 Apr;30(4):636-45
references: 21471484
references: Int J Qual Health Care. 2006 Apr;18(2):145-51
references: 16396939
references: PLoS Med. 2009 Sep;6(9):e1000094
references: 19753107
references: Chirurg. 2003 Dec;74(12):1149-55
references: 14673538
references: N Engl J Med. 1989 Nov 9;321(19):1306-11
references: 2677732
references: Qual Manag Health Care. 1992 Fall;1(1):1-8
references: 10131641
references: Implement Sci. 2009 Sep 28;4:64
references: 19785754
references: J Clin Epidemiol. 2010 Dec;63(12):1308-11
references: 20656455
references: J Qual Clin Pract. 2001 Sep;21(3):50-5
references: 11892822
references: Crit Care. 2009;13(6):210
references: 20064195
references: JAMA. 1999 Oct 20;282(15):1458-65
references: 10535437
references: Manag Care Q. 1993 Spring;1(2):43-52
references: 10130359
references: Kidney Int. 2012 Jun;81(12):1167-71
references: 22534963
references: Jt Comm J Qual Patient Saf. 2010 Oct;36(10):468-73
references: 21548508
references: J Am Med Inform Assoc. 2007 Jan-Feb;14(1):10-5
references: 17068349
references: Aust Health Rev. 2005 Feb;29(1):94-104
references: 15683361
references: Health Aff (Millwood). 2012 Mar;31(3):593-601
references: 22392671
references: Prog Transplant. 2011 Mar;21(1):43-52
references: 21485942
references: BMJ. 2004 Jun 19;328(7454):1490
references: 15205295
references: Pediatr Nephrol. 2009 Apr;24(4):687-96
references: 18800230
references: Health Aff (Millwood). 2012 Apr;31(4):797-805
references: 22492897
references: Qual Prim Care. 2013;21(2):123-30
references: 23735693
references: Arch Intern Med. 1993 Dec 13;153(23):2646-55
references: 8250661
references: BMC Med. 2010 May 27;8:31
references: 20507550
references: Acad Pediatr. 2012 Jul-Aug;12(4):312-8
references: 22634077
references: Pediatrics. 2008 Dec;122(6):1191-5
references: 19047233
references: Health Serv Res. 2005 Apr;40(2):499-516
references: 15762904
references: Pediatrics. 2000 Nov;106(5):1006-12
references: 11061767