ArticleHealth services research2005
Critical pathway effectiveness: assessing the impact of patient, hospital care, and pathway characteristics using qualitative comparative analysis.
Article in Health services research, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- The use of Qualitative Comparative Analysis (QCA) to address causality in complex systems: a systematic review of research on public health interventions.BMC public health · 2021Pooled it
- Characteristics of Case Management in Primary Care Associated With Positive Outcomes for Frequent Users of Health Care: A Systematic Review.Annals of family medicine · 2019Pooled it
- Pooled it
- Effects of clinical pathways in the joint replacement: a meta-analysis.BMC medicine · 2009Pooled it
- Patient participation in postoperative care activities in patients undergoing total knee replacement surgery: Multimedia Intervention for Managing patient Experience (MIME). Study protocol for a cluster randomised crossover trial.BMC musculoskeletal disorders · 2016Trial
- A cluster randomized controlled trial of a clinical pathway for hospital treatment of heart failure: study design and population.BMC health services research · 2007Trial
- Evaluation of clinical application of Korean medicine standard clinical pathway in a public hospital.World journal of clinical cases · 2025Article
- A novel Canadian multidisciplinary acute care pathway for people hospitalised with a diabetic foot ulcer.International wound journal · 2023Article
- Enabling System Functionalities of Primary Care Practices for Team Dynamics in Transformation to Team-Based Care: A Qualitative Comparative Analysis (QCA).Healthcare (Basel, Switzerland) · 2023Article
- Integrating case management for patients with complex needs in the ground practice: the importance of context in evaluative designs.Health research policy and systems · 2023Article
- Experiences of using clinical pathways in hospitals: Perspectives of quality improvement personnel.Nursing open · 2023Article
- Qualitative comparative analysis of the implementation fidelity of a workplace sedentary reduction intervention.BMC public health · 2022Article
- Mind the Differences: How Diagnoses and Hospital Characteristics Influence Coordination in Cancer Patient Pathways.International journal of environmental research and public health · 2021Article
- Innovations in Mixed Methods Evaluations.Annual review of public health · 2019Review
- The Impact of a Clinical Asthma Pathway on Resident Education.BioMed research international · 2018Article
- Implementation and Evaluation of a Clinical Pathway for Pancreaticoduodenectomy Procedures: a Prospective Cohort Study.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2017Article
- The importance of clinical pathways and protocols in pediatric nephrology.Pediatric nephrology (Berlin, Germany) · 2014Review
- Using qualitative comparative analysis to understand and quantify translation and implementation.Translational behavioral medicine · 2014Article
- Outcomes of Critical Pathway in Laparoscopic and Open Surgical Treatments for Gastric Cancer Patients: Patients Selection for Fast-Track Program through Retrospective Analysis.Journal of gastric cancer · 2013Article
- Development of integrated care pathways: toward a care management system to meet the needs of frail and disabled community-dwelling older people.International journal of integrated care · 2013Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo qualitatively describe patient, hospital care, and critical pathway characteristics that may be associated with pathway effectiveness in reducing length of stay. DATA SOURCES/STUDY
settingAdministrative data and review of pathway documentation and a sample of medical records for each of 26 surgical critical pathways in a tertiary care center's department of surgery, 1988-1998. STUDY
designRetrospective qualitative study. DATA COLLECTION/ABSTRACTION
methodsUsing information from a literature review and consultation with experts, we developed a list of characteristics that might impact critical pathway effectiveness. We used hypothesis-driven qualitative comparative analysis to describe key primary and secondary characteristics that might differentiate effective from ineffective critical pathways. PRINCIPAL
findings" All 7 of the 26 pathways associated with a reduced length of stay had at least one of the following characteristics: (1) no preexisting trend toward lower length of stay for the procedure (71 percent), and/or (2) it was the first pathway implemented in its surgical service (71 percent). In addition, pathways effective in reducing length of stay tended to be for procedures with lower patient severity of illness, as indicated by fewer intensive care days and lower mortality. Effective pathways tended to be used more frequently than ineffective pathways (77 versus 59 percent of medical records with pathway documents present), but high rates of documented pathway use were not necessary for pathway effectiveness.
conclusionsCritical pathway programs may have limited effectiveness, and may be effective only in certain situations. Because pathway utilization was not a strong predictor of pathway effectiveness, the mechanism by which critical pathways may reduce length of stay is unclear.
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