Difference between clinical pathway and clinical guidelines

[Lanie_82NS]

Hi all! I've read the long not user friendly definitions about these two in my book. However could someone please put in layman terms what the difference between clinical pathway and clinical practice guidelines is?

[HouTx, BSN, MSN, EdD]

Don't feel bad - this is just one example of why healthcare is so confusing.

In my experience, Guidelines are developed based on research findings. They are intended help clinical professionals make general decisions about treating patients with a particular problem or diagnosis. For instance, there is clear evidence about VBACS (lady partsl birth after c-section) ... what works and what doesn't .... that has been incorporated into a guideline from ACOG (American Congress of Obstetricians and Gynecologists). Most clinical specialty organizations devote quite a bit of time on the development of guidelines for their members. These guidelines (from professional organizations) are also used as a basis for organizational policies.

Clinical pathways are also a type of guideline, but they include a lot of other stuff. They are intended to serve as an example of how the care of each patient with a particular problem/illness is supposed to be organized in that facility. Each Pathway is based upon the expected length of stay and usually includes information about multidisciplinary events that are supposed to happen on a day-by-day basis during that time period. They include things like patient education, discharge planning, etc. that is NOT included in a Clinical Guideline. Pathways are used to monitor care processes - usually by Case Management & Quality folks. They compare the actual treatment to the pathway in order to make sure it is on track. If something is out of whack - such as more lab tests being performed - it will trigger additional actions to get the patient back on the pathway track if possible.

An important side note - there is always a disclaimer on any of these documents... stating something like "the information in this document cannot be substituted for the clinical judgement of a qualified professional". Basically, although guidelines are a helpful, the actual decisions about care must always be made by physicians and other providers.

[Lanie_82NS]

Thank you for putting that in an understandable format! :)