[Clinical pathways: experiences, expectations, and perspectives].

Abstract

Due to economic necessities, existing reserves in clinical practice have to be used efficiently. The presentation of medical activity and systematic illustration of medical decisions in the form of clinical pathways constitute important tools to ensure the quality of patient care under fiscal pressure caused by the DRG system. To successfully establish clinical pathways, the architecture of the standard operating procedures developed specifically for a hospital must adequately reflect medical concerns and patient-related needs. The concept of necessity for the good of the patient applies in this instance rather than the principle of the complete depiction of all medical processes. Organizing the implementation into clinical practice should be assured and monitored. The standard operating procedures should be regularly adapted to suit medical developments. Success with the procedure should be reported and deviations from predetermined targets should be documented. A clinical pathway does not represent an administrative end in itself but rather a part of a higher control system that helps to improve the utilisation of the hospital's resources in terms of reliability and quality of patient care.