Clinical Care Pathways

Clinical care pathways have been defined as “complex intervention(s) for the mutual decision making and organization of care processes for a well-defined group of patients during a well-defined period” with the purpose of enhancing the quality of patient care. They can be utilized to improve the efficiency of healthcare delivery to decrease healthcare costs, as well as improve patient outcomes by implementing standardized and evidence-based interventions. In the surgical setting, clinical care pathways are best exemplified by the enhanced recovery after surgery (ERAS) protocols. These ERAS protocols function to optimize the patient preoperatively, decrease perioperative stress, maintain normal postoperative physiologic function, and accelerate recovery time. Effective implementation of ERAS protocols requires involving many different disciplines including, but not limited to, surgeons, anesthesiologists, nursing staff, dietitians, and physical therapists. After protocols have been implemented, the process should be audited in order to document adherence to the protocol and patient outcomes. There is a large body of literature demonstrating that clinical care pathways across many surgical specialties are safe and effective at reducing healthcare costs while improving patient outcomes.