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  • Are emergency department clinical pathway interventions adequately described, and are they delivered as intended? A systematic review

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    AdjemianPUB5589.pdf (240.4Kb)
    Author(s)
    Adjemian, R
    Moradi Zirkohi, A
    Coombs, R
    Mickan, S
    Vaillancourt, C
    Griffith University Author(s)
    Mickan, Sharon M.
    Year published
    2017
    Metadata
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    Abstract
    Introduction: The accurate reproduction of clinical interventions and the evaluation of provider adherence in research publications improve the evaluation and implementation of research findings into clinical practice. We sought to examine the proportion of clinical pathway publications in an emergency department setting that adequately reported the following: (1) the exact reproduction of the clinical pathway that was implemented in the study, (2) the adherence to and correct execution of the clinical pathway intervention, and (3) the presence of a pre-implementation education phase. Methods: We performed a descriptive ...
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    Introduction: The accurate reproduction of clinical interventions and the evaluation of provider adherence in research publications improve the evaluation and implementation of research findings into clinical practice. We sought to examine the proportion of clinical pathway publications in an emergency department setting that adequately reported the following: (1) the exact reproduction of the clinical pathway that was implemented in the study, (2) the adherence to and correct execution of the clinical pathway intervention, and (3) the presence of a pre-implementation education phase. Methods: We performed a descriptive systematic review of the literature from 2006 to 2015 using MEDLINE, EMBASE, CENTRAL, and CINAHL. All types of prospective trial designs were eligible. Validated clinical pathway criteria were used to identify relevant publications. Two reviewers independently collected data using a piloted data abstraction tool. Risk of bias was assessed using the Cochrane Effective Practice and Organization of Care Group Risk of Bias Tool and the Newcastle-Ottawa Scale. Results: We identified 5947 publications, 44 of which met our inclusion criteria. The formal clinical pathway was fully reproduced in 27 (61%) publications, partially reproduced in 9 (21%), and not reproduced in 8 (18%). Only 14 (32%) studies reported whether at least one decision step was executed correctly. The presence of a pre-implementation education phase was reported in 33 (75%) studies. Conclusion: The underreporting of intervention elements may present a barrier to both the evaluation and accurate replication of clinical pathway interventions. These finding may be useful for the elaboration of complex intervention reporting guidelines, improved reporting in future clinical pathway publications, and improved knowledge translation and exchange of clinical pathway interventions.
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    Journal Title
    International Journal of Care Coordination
    Volume
    20
    Issue
    4
    DOI
    https://doi.org/10.1177/2053434517732507
    Copyright Statement
    Adjemian et al, Are emergency department clinical pathway interventions adequately described, and are they delivered as intended? A systematic review, International Journal of Care Coordination, Vol. 20(4) 148–161, 2017. Copyright 2017 The Authors. Reprinted by permission of SAGE Publications.
    Subject
    Clinical sciences not elsewhere classified
    Publication URI
    http://hdl.handle.net/10072/370489
    Collection
    • Journal articles

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