Development of a program theory for clinical pathways in hospitals: protocol for a realist review

Systematic Reviews

卷:8

Gary Groot¹  Adegboyega K. Lawal²  Donna Goodridge³  Shannon Scott⁴  Leigh Kinsman⁵ 

[1] College of Medicine, University of Saskatchewan;

[2] College of Pharmacy and Nutrition, University of Saskatchewan;

[3] Department of Medicine, College of Medicine, University of Saskatchewan;

[4] Faculty of Nursing, University of Alberta Edmonton;

[5] University of Newcastle and Mid-North Coast Local Health District, Port Macquarie Base Hospital;

关键词: Clinical pathways;    Realist review;    Hospitals;    Mechanisms;    Implementation;    Evaluation;   

DOI  :  10.1186/s13643-019-1046-0

来源: DOAJ

【 摘 要 】

Abstract Background Despite the increased utilization of clinical pathways (CPWs) as a strategy to improve patient and system outcomes in hospitals, there remain ongoing challenges with their conceptualization, implementation, and evaluation. Theories that explain how CPWs work in hospitals are lacking, making it difficult to identify important factors for sustaining changes arising from CPWs implemented in hospitals. The objective of this realist review is to develop a program theory for CPWs in hospitals. Methods This is a protocol for a realist review. The review will use a six-step iterative process to develop a program theory for CPWs in hospitals: (1) development of a preliminary program theory; (2) search strategy and literature search; (3) study selection and appraisal; (4) data extraction; (5) data analysis and synthesis; and (6) stakeholder engagement. In addition to searching the gray literature and contacting authors, we will search electronic databases such as MEDLINE, NHSEED, CINAHL EBSCO, HMIC, and PsycINFO. Studies will be included based on their ability to provide data that test some aspect of the program theory. Two independent reviewers will select, screen, and extract data related to the program theory from all relevant sources. A realist logic of analysis will be used to identify all context-mechanism-outcome heuristics that explains how CPWs implemented in hospitals translates to better health system outcomes. Discussion Overall, the review aims to develop a program theory for CPWs in hospitals and to explore how, why, to what extent, and in what contexts does the implementation of CPWs in hospitals contribute to better health system outcomes. As a result, the review will provide a theoretical framework of how CPWs work in hospitals. Systematic review registration PROSPERO CRD42018103220

【 授权许可】

Unknown