Evidence for the contemporary clinical pathway quality measures: Literature review

Abstract

Objectives: Clinical pathway effect on improving the healthcare quality still underestimated. An overview on clinical pathway current practice overview will be presented in the context of this paper. Methods/Statistical analysis: A search for the medical literature was conducted to screen the contemporary evidence. We focused on finding the gold standard for clinical pathway quality measures and the current status of clinical pathway in Malaysia. Various databases (MEDLINE, EMBASE, Pub Med, COHRANCE library and CINAHEL) have been screened for 2000 to 2015 studies. Checklist of the preferred reporting items for systematic reviews and meta-analyses has been used as a guide for reporting. Findings: The search has identified 720 documents, of which 315 (44%) met the inclusion criteria of this study. Twenty meta-analysis studies have been found, while only nine have completely fulfilled the search inclusion criteria. Mostly they discussed the length of stay, patient outcome and cost from RCT (randomized clinical trial) or EXP (experimental design) evidence as a quality indicator for the clinical pathway which may underrepresent the complexity nature of clinical pathway and ignored many aspects of care. The majority of publications in Malaysia found from (UKM) with similar heterogeneous focus on the outcome measures to what have been found in the overall literature. Interestingly, we found that no meta-analysis study has been conducted in Malaysia for clinical pathway. Application/Improvements: Current research on clinical pathway still limited. More Studies on the effect of clinical pathway on quality of care still needed with emphasize on the cofounding factors.