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Clinical pathway


Clinical pathways, also known as care pathways, critical pathways, integrated care pathways, or care maps, are one of the main tools used to manage the quality in healthcare concerning the standardization of care processes. It has been shown that their implementation reduces the variability in clinical practice and improves outcomes. Clinical pathways promote organized and efficient patient care based on evidence based practice. Clinical pathways optimize outcomes in the acute care and home care settings. Generally clinical pathways refer to medical guidelines. However a single pathway may refer to guidelines on several topics in a well specified context.

Multidisciplinary management tool based on evidence-based practice for a specific group of patients with a predictable clinical course, in which the different tasks (interventions) by the professionals involved in the patient care are defined, optimized and sequenced either by hour (ED), day (acute care) or visit (homecare). Outcomes are tied to specific interventions.

According to an article in the Journal of Clinical Pathways, the concept of clinical pathways has different meanings to different stakeholders. Managed care organizations often view clinical pathways in a similar way as they view care plans, in which the care provided to a patient is definitive and deliberate. Clinical pathways can range in scope from simple medication utilization to a comprehensive treatment plan. Clinical pathways aim for greater standardization of treatment regimens and sequencing as well as improved outcomes, from both a quality of life and a clinical outcomes perspective; thus fulfilling the goal of the Triple Aim.

The clinical pathway concept appeared for the first time at the New England Medical Center (Boston, United States) in 1985 inspired by Karen Zander and Kathleen Bower. Clinical pathways appeared as a result of the adaptation of the documents used in industrial quality management, the Standard Operating Procedures (SOPs), whose goals are:

In April, 1991, VNA FIRST, in consultation with the Center for Case Management, Inc., South Natick, MA, developed the Home Health Care Map Tools (now called VNA FIRST Home Care Steps Protocols.)


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