An Evaluation of the Quality of Integrated Care Pathway Development in the UK National Health Service

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Abstract
An integrated care pathway (ICP) is an outline of planned care for a specific patient group. It highlights usual practice that is evidence-based, from which variations occur as health-care professionals use their professional judgement. The objectives of the study were to identify the key elements within an ICP, to formulate a checklist utilizing the ICP key elements, and to evaluate ICPs available from the UK National electronic Library for Health (NeLH) against the checklist. An ICP key elements checklist was produced from a review of ICP literature. In all, 90% of the ICPs evaluated contained a plan of anticipated care along some form of timeline, including processes and outcomes. Also, 70% of the ICPs evaluated did not contain a variance-recording framework. In addition, 70% of the ICPs evaluated did not contain any evidence of evidence-based best practice. This study shows that there is wide variability in the quality of the ICPs being developed in the UK National Health Service (NHS), and that the development of ICPs in many health-care organizations is inadequate. Variability of the ICPs being developed will have a direct impact on the quality of patient care, and improvements in care and service delivery may not be identified, implemented or reviewed. It is recommended that a tool be produced, which would provide a standard framework for NHS staff to follow when developing ICPs.

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