Integrated care pathways in orthopaedics: A literature review

SummaryIntegrated care pathways are becoming increasingly popular and may present considerable advantages for care delivery in orthopaedic settings. This paper reports on the application and the utility of integrated care pathways within the orthopaedic environment. The possible wide ranging benefits include the streamlining and centralisation of patient documentation in addition to the positive influence on the quality of service that is enabled by the enhanced communication between all members of the multi-disciplinary team involved in the delivery of care. As approaches to care are planned and standardised these instruments enable the generation of clear, comprehensive data on agreed clinical outcomes and the variance analysis that can be produced can potentially contribute to the effective auditing of clinical practice. While there are considerable advantages outlined in the literature there does remain some scepticism regarding the utility of these instruments and some doubt whether they achieve the standardisation of care in practice claimed due to variances in their application between institutions and settings. Furthermore, there is concern among some health professionals that the application and use of care pathways in the clinical setting may have legal and or ethical implications.