Development and implementation of a clinical pathway programme in an acutecare general hospital in Singapore

A critical or clinical pathway defines the optimal care process, sequencing and timing of interventions by doctors, nurses and other health care profe ssionals for a particular diagnosis or procedure. Clinical pathways are det -eloped through collaborative efforts of clinicians, case managers, nurses, pharmacists, physiotherapists and other allied health care professionals w ith the aim of improving the quality of patient care, while minimizing cost to the patient. The use of clinical pathways has increased over the past decade in the USA, the UK, Australia, and many other developed countries. However, its use in the developing nations and Asia has been sporadic. To the author's knowled ge, there is to date, no published literature on the use and impact of clin ical pathways on the quality and cost of patient care in the Asian health c are setting. This paper provides a qualitative account of the development a nd implementation of a clinical pathway programme (using the example of pat ients with uncomplicated acute myocardial infarction) in an acute care gene ral hospital in Singapore. The paper concludes that clinical pathways, when implemented in the context of an acute care hospital, can result in improv ements in the care delivery process.