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Clinical pathways: a departure from the art of medicine

Ralph K Nanan, Alison S Poulton and Bernard L Champion
Med J Aust 2012; 196 (2): . || doi: 10.5694/mja11.11391
Published online: 6 February 2012

Is canonical thinking inhibiting the flexibility and innovation required for expert clinical reasoning?

The idea of clinical pathways was developed in 1985,1 with the intention of improving patient care and use of health resources. Since then, use of clinical pathways has proliferated, dominating clinical decision making in Australia and abroad. Important features of clinical pathways include a practical focus on the patient journey and a patient-centred multidisciplinary team approach. Clinical pathways are ideally based on best available evidence and expert opinion and should lead to a high degree of consistency for safe and sound decision making for common or serious clinical scenarios. Positive impacts of clinical pathways have been documented, including cost savings from minimising non-indicated investigations or treatments, and improved clinical outcomes and reduced adverse events.2


  • Sydney Medical School Nepean, University of Sydney, Sydney, NSW.



Competing interests:

No relevant disclosures.

  • 1. Audimoolam S, Nair M, Gaikwad R, Qing C. The role of clinical pathways in improving patient outcomes. Feb 2005. http://web.cs.dal.ca/~asharma/OWL/Role%2520of%2520Clinical%2520Pathways.pdf (accessed Oct 2011).
  • 2. Lugtenberg M, Burgers JS, Westert GP. Effects of evidence-based clinical practice guidelines on quality of care: a systematic review. Qual Saf Health Care 2009; 18: 385-392.
  • 3. Scott M, Sampson J, Crowch T. Automation: pilots as machine-minders or as professional aviators? Aviation Today 2005; 25 Apr.
  • 4. Norman G. Building on experience — the development of clinical reasoning [editorial]. N Engl J Med 2006; 355: 2251-2252.

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