1.

1 Clinical Pathway

There is many other name of Clinical pathway such as Anticipated Recovery Pathway (ARPs),
Multidisciplinary Pathways of Care (MPCs), Care Protocols, Integrated Care Pathways, Pathways of Care,
Care Packages, Collaborative Care Pathways, Care Maps, Care Profiles.

Clinical pathways are one of the most widely used and rapidly evolving disease management tools in
the past 15 years, mainly because of the large number of research reports showing that clinical pathways
have the potential to reduce unnecessary variations in services so as to improve clinical outcomes and
savings in resource use (finance). To ensure service quality, there is a need for minimum and standard
clinical pathways.

Clinical Pathway is a flow of patient service activities that are specific to a particular disease or action,
from patient admission to patient discharge which is an integration of medical services, nursing services,
pharmaceutical services and other health services (67–69). Clinical pathways are very instrumental in
patient recovery, length of stay (70) and health financing. Every hospital can define Clinical Pathways based
on facilities and doctors they have.

The purpose of implementing clinical pathway is primarily to (67) select the right people can work in
the right order, spell out the right thing at the right time, in the right place, with the right outcome, taking
into account the patient's experience; improve service quality by paying attention to patient outcomes,
patient safety, increasing patient satisfaction and optimizing resource use; promote patient satisfaction
through increasing education to patients (for example by providing more precise information about service
plans).

There several reasons for developing Clinical Pathway such as first is to improve patient care by
improving the quality of patient care through consistent management: patient involvement, identify &
measuring improvements in patient care, measuring outcome. Second is to maximize the efficient use of
resources by reducing unnecessary documentation & overlap, reduced length of hospital stay. Third is to
help identify & clarify the clinical processes by ensuring continuity of patient care by reducing unnecessary
variations. Forth is to support clinical effectiveness, clinical audit & risk management. CP also provides an
appropriate framework to promote and measure the success of clinical effectiveness cycle, which
encompasses: evidence based practice, clinical audit, patient involvement, multi-disciplinary, multi-
professional working, outcome measures & clinical benchmarking.
 Clinical pathways used in hospitals as quality control devices must be truly planned, compiled,
implemented and evaluated on clinical pathways systematically. Clinical pathways are also used to
calculate treatment costs by calculating the cost of each activity on each Clinical Pathway based on unit
costs.

On the INA-CBGs tariff setting, the varied Clinical Pathways are not detailed and are taken the best
average of financing from hospital references that contribute to the preparation of the INA-CBG tariff (68).

67. RSUD Ende. Clinical Pathway: Apa, Mengapa, dan Bagaimana? 2014 Nov.

68. Djasri H. Peran Clinical Pathways dalam Sistem Jaminan Sosial Nasional Bidang Kesehatan. :5.

69. Cheah J. Development and implementation of a clinical pathway programme in an acute care
general hospital in Singapore. International Journal for Quality in Health Care. 2000 Oct 1;12(5):403–12.