CLINICAL PATHWAYS: EFFECT ON INTERPROFESSIONAL COLLABORATION IN A HOSPITAL SETTING
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Background Effective collaboration between healthcare professionals helps to offer continuous and high-quality care to the patients. In interprofessional teamwork, healthcare professionals from multiple specialties, knowledge and skillsets come together for a common goal. There are many interventions available for the improvement of teamwork in healthcare. This review explores the role of clinical pathways (CPW) on teamwork in a hospital setting. Clinical Pathways are quality management tools, useful in translating recommendations from clinical practice guidelines into improved care processes. The subgroup analysis in this review is guided by the systematic review from Rotter et al. (2010). Objectives To investigate the effect of clinical pathways (CPWs) on interprofessional collaboration in hospital settings compared to usual care. Search methods For this review, we utilized the studies identified in the 2010 review by Rotter et al. and 2017 update from the following databases from 2008 up to 2017: Cochrane Central Register of Controlled Trials (CENTRAL) and bibliographic databases including MEDLINE, Embase, CINAHL, Amed, PsycINFO, HMIC, Cochrane-HTA, ClinicalTrials.gov, WHO ICTRP, Cochrane-NHS EED and Global Health. We also searched the reference lists of relevant articles. Selection criteria We included randomized trials, non-randomized trials, interrupted time series studies, controlled before-after. The subgroup analysis in this review will only include those studies that report on outcomes related to teamwork and interprofessional collaboration in a hospital setting Data collection and analysis Two review authors independently screened all titles, abstracts and full-text manuscripts to assess eligibility and methodological quality. The studies were grouped and assessed according to those comparing clinical pathways with usual care and those comparing clinical pathways as part of a multifaceted intervention with usual care. Results Out of the 39 studies utilized from the overarching systematic review by Rotter et al. (2010), six studies met the inclusion criteria. The search also yielded studies with low quality (high risk of bias), and teamwork related outcomes were poorly reported. A meta-analytic comparison was not useful and limited our ability to identify mechanisms which could explain how CPW enhance teamwork. Conclusion The poor reporting of teamwork related outcomes in the studies was a challenge in this review and lacked critical information on the potential mechanism by which CPW affects teamwork. Despite this limitation, we were able to identify team relevant information. Studies revealed that CPWs might be useful in improving documentation. Documentation and clear communication are facilitators in interprofessional conflict management, decision-making skills, adherence to the CPW, and teams support for innovation.
DegreeMaster of Science (M.Sc.)
DepartmentPharmacy and Nutrition
CommitteeKalra, Jawahar (Jay); Dobson, Roy; Kinsman, Leigh; Blackburn, David; Fowler-Kerry, Susan
Copyright DateMarch 2021
Clinical pathways, interprofessional collaboration, teamwork