Comparative Analysis of Clinical Pathway Appraisal Tools and Reporting Standards_Chinese Journal of Evidence-Based Medicine

Authors：

 CUIQi ^1,2,3,4 , HUANGDi ^2,3,4 , SONGXu-ping ^2,3,4 , TIANJin-hui ^2,3 ,  YANGKe-hu ^1,2,4

1. The First Clinical Medicine College, Lanzhou University, Lanzhou 730000, China;
2. Evidence-Based Medicine Center of Lanzhou University, School of Basic Medical Science of Lanzhou University, Lanzhou 730000, China;
3. Key Laboratory of Evidence Based Medicine and knowledge Translation of GanSu Province, Lanzhou 730000, China;
4. School of Public Health, Lanzhou University, Lanzhou 730000, China;

Corresponding?author：

YANGKe-hu, Email: kehuyangebm006@126.com

Keywords：

Clinical pathway; Appraisal tool; Reporting standard; Item

DOI：

10.7507/1672-2531.20150141

Video：

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Objective To acquaint the development process and item composition of the appraisal tools and reporting standards of clinical pathways worldwide, in order to improve the development and evaluation of clinical pathways. Methods We searched databases including PubMed, EMbase, Web of Science, CBM, CNKI and WanFang Data for articles about the appraisal tools and reporting standards of clinical pathways from inception to Jan, 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and compared the difference in development process and item composition among included appraisal tools and reporting standards of clinical pathways. Results A total of 7 appraisal tools and reporting standards were included. Among them, 3 were from UK, 1 from China, 1 from Australia, 1 from Belgium, and 1 from Saudi Arabia. All included appraisal tools contained 4 to 15 domains and 14 to 99 items. Based on the comparison of different domains and items of included appraisal tools, "Clinical Pathway Management Guidelines" published by the National Health and Family Planning Commission of the People's Republic of China and the research of Vannhaecht, we identified 17 key elements of clinical pathway as follows:organizational commitment, pathway project management, format of doc, content of pathway, multidisciplinary involvement, variance management, EBM/guidelines, maintenance of pathway, accountability, patient involvement, development of pathway, additional support systems & documents, operational arrangement, implementation, outcome management, safety and organization of the care process. Conclusion Currently, the appraisal tools and reporting standards of clinical pathways are rudimentary, so we desperately needs to establish mature appraisal tool and reporting standard of clinical pathways to guide the development and implementation of clinical pathway, so as to improve their application effects in clinical practice and medical quality.

Citation： CUIQi, HUANGDi, SONGXu-ping, TIANJin-hui, YANGKe-hu. Comparative Analysis of Clinical Pathway Appraisal Tools and Reporting Standards. Chinese Journal of Evidence-Based Medicine, 2015, 15(7): 810-815. doi: 10.7507/1672-2531.20150141 Copy

1.	梁銘會,武廣華,鄭紅,等.臨床路徑研究與實踐概述.中國醫療管理科學,2013,4(1):17-20.
2.	中華人民共和國國家衛生和計劃生育委員.衛生部關于"十二五"期間推進臨床路徑管理工作的指導意見.[2012-10-18].Available at:http://www.moh.gov.cn/mohyzs/s3586/201210/56150.shtml.
3.	齊德廣,秦銀河,李書章,等.臨床路徑應用于剖腹產手術效果分析.中國醫院管理,2003,23(5):28-29.
4.	成翼娟,戴紅霞,寧寧.臨床路徑在膝關節鏡手術患者中的應用研究.中華護理雜志,2004,39(7):489-491.
5.	劉衛英,黃小紅,趙美君.臨床路徑在甲狀腺良性腫瘤手術患者中的應用研究.中國實用護理雜志,2005,21(4):24-25.
6.	孫紅梅,宮印成,王敬梅,等.實施臨床路徑的應用效果研究.中國衛生資源,2008,11(1):16-18.
7.	馬燕蓉,姚炯.臨床路徑的應用效果分析.中國病案,2012,13(3):27-28.
8.	Whittle CL,McDonald PS,Dunn L,et al.Developing the Integrated Care Pathway appraisal tool (ICPAT):A pilot study.Journal of Integrated Care Pathways,2004,8(2):77-81.
9.	McSherry R,Scott M,Williams S.The importance of information technology:a regional guide to the development,implementation and evaluation of integrated care pathways.Part 2.Journal of Integrated Pathways,2003,7(2):59-70.
10.	Croucher M.An evaluation of the quality of integrated care pathway development in the UK National Health Service.Journal of Integrated Pathways,2005,9(1):6-12.
11.	Vanhaecht K,De Witte K,Depreitere R,et al.Development and validation of a care process self-evaluation tool.Health Services Management Research,2007,20(3):189-202.
12.	王思成,劉建平,李慧,等.循證中醫臨床路徑的報告規范.中西醫結合學報2010,8(9):819-823.
13.	Hassan IS.Knowledge translation through clinical pathways:Principles for practical development and successful use.Saudi Journal of Kidney Diseases and Transplantation,2013,24(2):351.
14.	Mallock N,Braithwaite J.A template for clinical pathway design based on international evidence.Clinical Governance Bulletin,2005,5(5):2-4.
15.	De Luc KE,Whittle C.An integrated care pathway appraisal tool:a ‘badge of quality’.Journal of Integrated Pathways,2002,6(1):13-17.
16.	Vanhaecht K,Witte KD,Depreitere R,et al.Clinical pathway audit tools:a systematic review.Journal of Nursing Management,2006,14(7):529-537.
17.	Institute of Medicine (US) Committee on Quality of Health Care in America.Crossing the quality chasm:A new health system for the 21st century.Washington (DC):National Academies Press (US);2001.
18.	Vlayen J,Aertgeerts B,Hannes K,et al.A systematic review of appraisal tools for clinical practice guidelines:multiple similarities and one common deficit.International Journal for Quality in Health Care,2005,17(3):235-242.
19.	Croucher M.Evaluation of the current knowledge and awareness of the integrated care pathway tool in a local health community.Journal of Integrated Pathways,2005,9(2):51-56.
20.	吳燕子,曹祝萍,馬集云,等.對臨床路徑應用中若干問題的探討.中國醫院管理,2008,28(5):23-24.
21.	Sarrechia M,Van Gerven E,Hermans L,et al.Variation in 17 obstetric care pathways:potential danger for health professionals and patient safety.Journal of Advanced Nursing,2013,69(2):278-285.
22.	Seys D,Deneckere S,Sermeus W,et al.The Care Process Self-Evaluation Tool:a valid and reliable instrument for measuring care process organization of health care teams.BMC health services research,2013,13(1):1-7.

1. 梁銘會,武廣華,鄭紅,等.臨床路徑研究與實踐概述.中國醫療管理科學,2013,4(1):17-20.
2. 中華人民共和國國家衛生和計劃生育委員.衛生部關于"十二五"期間推進臨床路徑管理工作的指導意見.[2012-10-18].Available at:http://www.moh.gov.cn/mohyzs/s3586/201210/56150.shtml.
3. 齊德廣,秦銀河,李書章,等.臨床路徑應用于剖腹產手術效果分析.中國醫院管理,2003,23(5):28-29.
4. 成翼娟,戴紅霞,寧寧.臨床路徑在膝關節鏡手術患者中的應用研究.中華護理雜志,2004,39(7):489-491.
5. 劉衛英,黃小紅,趙美君.臨床路徑在甲狀腺良性腫瘤手術患者中的應用研究.中國實用護理雜志,2005,21(4):24-25.
6. 孫紅梅,宮印成,王敬梅,等.實施臨床路徑的應用效果研究.中國衛生資源,2008,11(1):16-18.
7. 馬燕蓉,姚炯.臨床路徑的應用效果分析.中國病案,2012,13(3):27-28.
8. Whittle CL,McDonald PS,Dunn L,et al.Developing the Integrated Care Pathway appraisal tool (ICPAT):A pilot study.Journal of Integrated Care Pathways,2004,8(2):77-81.
9. McSherry R,Scott M,Williams S.The importance of information technology:a regional guide to the development,implementation and evaluation of integrated care pathways.Part 2.Journal of Integrated Pathways,2003,7(2):59-70.
10. Croucher M.An evaluation of the quality of integrated care pathway development in the UK National Health Service.Journal of Integrated Pathways,2005,9(1):6-12.
11. Vanhaecht K,De Witte K,Depreitere R,et al.Development and validation of a care process self-evaluation tool.Health Services Management Research,2007,20(3):189-202.
12. 王思成,劉建平,李慧,等.循證中醫臨床路徑的報告規范.中西醫結合學報2010,8(9):819-823.
13. Hassan IS.Knowledge translation through clinical pathways:Principles for practical development and successful use.Saudi Journal of Kidney Diseases and Transplantation,2013,24(2):351.
14. Mallock N,Braithwaite J.A template for clinical pathway design based on international evidence.Clinical Governance Bulletin,2005,5(5):2-4.
15. De Luc KE,Whittle C.An integrated care pathway appraisal tool:a ‘badge of quality’.Journal of Integrated Pathways,2002,6(1):13-17.
16. Vanhaecht K,Witte KD,Depreitere R,et al.Clinical pathway audit tools:a systematic review.Journal of Nursing Management,2006,14(7):529-537.
17. Institute of Medicine (US) Committee on Quality of Health Care in America.Crossing the quality chasm:A new health system for the 21st century.Washington (DC):National Academies Press (US);2001.
18. Vlayen J,Aertgeerts B,Hannes K,et al.A systematic review of appraisal tools for clinical practice guidelines:multiple similarities and one common deficit.International Journal for Quality in Health Care,2005,17(3):235-242.
19. Croucher M.Evaluation of the current knowledge and awareness of the integrated care pathway tool in a local health community.Journal of Integrated Pathways,2005,9(2):51-56.
20. 吳燕子,曹祝萍,馬集云,等.對臨床路徑應用中若干問題的探討.中國醫院管理,2008,28(5):23-24.
21. Sarrechia M,Van Gerven E,Hermans L,et al.Variation in 17 obstetric care pathways:potential danger for health professionals and patient safety.Journal of Advanced Nursing,2013,69(2):278-285.
22. Seys D,Deneckere S,Sermeus W,et al.The Care Process Self-Evaluation Tool:a valid and reliable instrument for measuring care process organization of health care teams.BMC health services research,2013,13(1):1-7.

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