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Local clinical pathways: from 'good ideas' to 'practicality' for general practitioners

Resource type
Authors/contributors
Title
Local clinical pathways: from 'good ideas' to 'practicality' for general practitioners
Abstract
INTRODUCTION There has been increased interest in the utility of clinical pathways by primary health care in New Zealand, although evaluation of their use has been limited. AIM To identify barriers and facilitators for the use of clinical pathways in one health region. METHODS Interviews with 15 general practitioners in the Western Bay of Plenty. A qualitative thematic analysis was undertaken, informed by the Diffusion of Innovation Framework. RESULTS Four themes were identified: learning to use the pathways, persuasion and decision to use, implementation and sustainability. Barriers to using the pathways included time pressure; scepticism; difficulty in portraying patients' clinical picture within a set pathway; technical difficulties and lack of support in obtaining knowledge; and practical implementation of the pathways in daily work. Facilitators included endorsement by opinion leaders; pathways directing workup and treatment stepwise towards referral; centralised information with resources available in the consultation; and reported increased acceptance of referrals by secondary care if pathways were used. DISCUSSION The development and implementation of health care initiatives requires an understanding of the local context. Knowledge about the specific, locally appreciated barriers and facilitators can inform future health-care developments. The Diffusion of Innovation Framework offers a practical model to understand effective implementation.
Publication
Journal of Primary Health Care
Volume
10
Issue
3
Pages
215-223
Date
10 2018
Journal Abbr
J Prim Health Care
Language
eng
DOI
10.1071/HC18023
ISSN
1172-6156
Short Title
Local clinical pathways
Library Catalog
PubMed
Extra
PMID: 31039936
Citation
Reyneke, A., Jaye, C., & Stokes, T. (2018). Local clinical pathways: from “good ideas” to “practicality” for general practitioners. Journal of Primary Health Care, 10(3), 215–223. https://doi.org/10.1071/HC18023
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