Project management approach to implement clinical pathways: An example for thyroidectomy

Abstract

Clinical pathway is a concept that from a managerial point of view promotes variance reduction in the delivery of health care and, therefore, is able to reduce costs. To achieve this, health care providers must improve efficiency in the use of resources while completing delivery of care in time with expected achievements in quality. Implementation of the clinical pathways for a specific disease requires a clear identification of tasks that compose the care delivery process by a multi-professional team including physicians, nurses, various therapists and/or health technologist and so on. From this perspective, implementing clinical pathways for a disease can be, therefore, conceptualized as an integrated project with many tasks. Hence, the management of the care delivery tasks in time nicely fits into project management, an operations research tool. With this conceptualization, we test the potential use of project management to organize the integrated care delivery tasks of the thyroid disease as a project. Probabilistic and deterministic project management models have been implemented and solved for a real case study to demonstrate the estimated duration for the clinical pathway, where critical activities must be carefully monitored by the caregiving team to reduce or eliminate the variation in care delivery.