An Integrated Care Pathway Appraisal Tool: A ‘Badge of Quality’

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Abstract
Integrated care pathways (ICPs) are being introduced as a tool to improve the quality of health care. Their local development usually involves some consensus-based approach which engages clinical staff in discussions about how to improve services. Whilst this has definite advantages, it also means that ICPs which are developed for ostensibly the same group of patients with a specific disease or condition will vary in content and quality. Many articles have been written expounding the benefits of using ICPs, but recently there have been a number of evaluations of ICPs which report little or no significant improvement in the quality of health care as a result of their introduction. Why is there this divergence of views about the value of ICPs? Could it be connected with the variability in quality of the ICPs being introduced? What is missing from many of the evaluations of ICPs undertaken so far is a consideration of how good those ICPs really are. This article describes an appraisal instrument for ICPs — the integrated care pathway appraisal tool (ICPAT) — which has been developed within the West Midlands region of the UK and which can provide a framework for assessing the quality of ICPs.