Care pathways lead to better teamwork: Results of a systematic review

Care pathways are often said to promote interprofessional teamwork. As no systematic review on pathway effectiveness has ever focused on how care pathways promote teamwork, the objective of this review was to study this relationship. We performed an extensive search of electronic databases and identified 26 relevant studies. In our analysis of these studies we identified 20 team indicators and found that care pathways positively affected 17 of these indicators. Most frequently positive effects were found on staff knowledge, interprofessional documentation, team communication and team relations. However, the level of evidence was rather low. We found Level II evidence for improved interprofessional documentation. We also found Level II evidence for increased workload; improved actual versus planned team size; and improved continuity of care. The studies most frequently mentioned the need for a multidisciplinary approach and educational training sessions in order for pathways to be successful. The systematic review revealed that care pathways have the potential to support interprofessional teams in enhancing teamwork. Necessary conditions are a context that supports teamwork and including appropriate active pathway components that can mediate an effect on team processes. To achieve this, each care pathway requires a clearly defined team approach customized to the individual teams’ needs.

► This review enhances understanding on how and in what circumstances care pathways work.
► Most frequently found effects were improved team knowledge, interprofessional documentation, communication and relations.
► A supportive context that puts care processes and teams in the frontline of concern, needs to be pursued.
► Teams involved in care pathways need to be trained to improve team processes and manage team conflicts appropriately.
► To be successful, each care pathway requires a clearly defined team approach, customized to the individual teams’ needs.