Clinical pathways, standards of care, practice guidelines

Clinical Pathway/Case Management Plan: A timeline of patient care activities and expected outcomes of care that address the plan of care of each discipline involved in the care of a particular patient. It is usually developed prospectively by an interdisciplinary healthcare team in relation to a patient’s diagnosis, health problem, or surgical procedure.

Standards of Care: Statements that delineate care that is expected to be provided to all clients. They include predefined outcomes of care clients can expect from providers and are accepted within the community of professionals, based upon the best scientific knowledge, current outcomes data, and clinical expertise.

Standards of Practice: Statements of acceptable level of performance or expectation for professional intervention or behavior associated with one’s professional practice. They are generally formulated by practitioner organizations based upon clinical expertise and the most current research findings.

Practice Guidelines (Guidelines): Systematically developed statements on medical practices that assist a practitioner in making decisions about appropriate diagnostic and therapeutic healthcare services for specific medical conditions. Practice guidelines are usually developed by authoritative professional societies and organizations such as the American Medical Association.

Clinical Pathway

Clinical pathways incorporate clinical guidelines, evidence-based guidelines and protocols for common diagnoses, conditions and procedures into algorithms. These algorithms are used by the multidisciplinary care team in providing care to the patient.

Items addressed on the clinical pathway may include:

  • Patient assessment and monitoring
  • Tests and procedures
  • Treatments
  • Consultations
  • Medications
  • Activity
  • Nutrition
  • Education
  • Targeted length of stay
  • Outcome Criteria
  • Notification for deviations

Standardizing treatments improves the continuity and coordination of care provided by all disciplines involved. This results in greater quality of care and decreased costs.  

Evidence-Based Guidelines

Evidence based practice is the process of applying the best available research results when making decisions about health care. Health care professionals who perform evidence-based practice use research evidence along with clinical expertise and patient preferences in providing care.

Practice Guidelines

Guidelines provide clinicians and patients the recommendations for screening, diagnostic and therapeutic actions that are known or believed to favorably affect the health outcomes of patients. Guidelines are not meant to replace the clinical judgement of the individual provider or establish a standard of care. They are meant to be flexible and are only considered recommendations.

Standards of Care

Where Guidelines are meant to be flexible, standards are a rigid set of criteria, meant to be followed under any circumstances. These are practices that are medically necessary for the management of a clinical condition.