Early Findings on the Use of Clinical Pathways for Management of Unwarranted Variation in Cancer Care.

Autor:	Jackman DM; Dana-Farber Cancer Institute, Boston, MA Harvard Medical School, Boston, MA Boston University School of Public Health, Boston, MA., Foster E, Hamilton JM, Tremonti C, Bunnell CA, Stuver SO, Jacobson JO
Jazyk:	angličtina
Zdroj:	American journal of medical quality : the official journal of the American College of Medical Quality [Am J Med Qual] 2022 Mar-Apr 01; Vol. 37 (2), pp. 103-110.
DOI:	10.1097/01.JMQ.0000749852.10699.bc
Abstrakt:	Clinical pathways have the potential to improve complex clinical decision-making in cancer care. The authors implemented pathways with customized content to assist oncologists to select treatments, aiming for an on-pathway rate of 70%-85%. Treatment decisions were captured as on or off pathway, and metrics were shared monthly with users. Oncologists were categorized into quintiles based on on-pathway performance during the first 90 days of use. On-pathway rates were then calculated for days 91-360 (N = 121). Median on-pathway quintile rates varied from 50% to 100% in the initial 90-day period. During follow-up, median on-pathway rates shifted into the prespecified goal range for all groups. Clinical pathways resulted in greater uniformity in medical oncology practice. Monthly feedback about usage, familiarity with the electronic platform, and regular content updates are some factors that may influence on-pathway rates. Clinical pathways hold promise to manage unwarranted variation in cancer care. (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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