Evidence map›Paper›PMID 32426636›Full record

ArticlePediatric quality & safety

Qualitative Study to Understand Pediatric Hospitalists and Emergency Medicine Physicians' Perspectives of Clinical Pathways.

Kimberly O'Hara, Melisa Tanverdi, Jennifer Reich, D David Scudamore, Amy Tyler, Leigh Anne Bakel

Abstract read
In one paragraph

Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Impact of an Inpatient COPD Care Pathway on Hospital Care Process and Outcome Metrics.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2025
    Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Kimberly O'HaraDepartment of Pediatrics, University of Colorado School of Medicine, Aurora, Colo.
Melisa TanverdiDepartment of Pediatrics, University of Colorado School of Medicine, Aurora, Colo.
Jennifer ReichDepartment of Sociology, University of Colorado, Denver, Colo.
D David ScudamoreDepartment of Pediatrics, University of Colorado School of Medicine, Aurora, Colo.
Amy TylerDepartment of Pediatrics, University of Colorado School of Medicine, Aurora, Colo.
Leigh Anne BakelDepartment of Pediatrics, University of Colorado School of Medicine, Aurora, Colo.

Funding

The ROUTT-B (Reduce Over-Utilized Tests and Treatments in Bronchiolitis) Study: Developing a Roadmap for De-ImplementationK08HS026512 · AHRQ · UNIVERSITY OF COLORADO DENVER · PI TYLER, AMY · 2019 to 2023
$674k
AHRQ HHS K08 HS026512
6 · The paper itself

Abstract

introductionHealthcare costs are rising, and clinical pathways (CPW) are one means to promote high-value care by standardizing care and improving outcomes without compromising cost or quality. However, providers do not always follow CPW, and our understanding of their perceptions is limited. Our objective was to examine pediatric hospital medicine (PHM) and pediatric emergency medicine (PEM) physician perspectives of CPW.

methodsWe conducted semistructured, in-depth, one-on-one qualitative interviews with PHM and PEM physicians between February 2017 and August 2017. Interviews were audio-recorded, professionally transcribed, and accuracy verified. Using an inductive analytic strategy, we systematically coded the data to identify themes.

resultsWe interviewed 15 PHM and 15 PEM physicians. These providers identified many benefits and limitations of CPW, which positively or negatively impact resource utilization, communication, education of personnel, patients, and families, as well as practice behaviors and attitudes. Perceived benefits included (1) reduction of unnecessary utilization, (2) standardization of care, (3) improved communication, (4) education of oneself and others, and (5) confidence and validation when actions align with CPW. Limitations of CPW were (1) resource utilization for revisions, updates, and dissemination; (2) "tunnel vision" and cognitive biases; (3) loss of autonomy; (4) prescriptive medicine; (5) information overload; (6) pressure to adhere; and (7) guilt if actions do not align with CPW.

conclusionsCPW are tools with advantages and disadvantages that are used and viewed differently by providers. Such insight into how physicians perceive CPW may help to optimize hospital improvement work and enhance high-value care.

Identifiers

PMID32426636
PMCPMC7190254

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.