Clinical pathways — a Middle–Eastern perspective

Abstract

Clinical pathways were first developed at Sheikh Khalifa Medical Centre (SKMC), Abu Dhabi, in 2001 – one year after the facility first opened. Long lengths of stay and unjustified variances in clinical practice were the main reasons for the development. Laparoscopic cholcyctectomy was the first to be implemented six months after development began. Convincing the workgroup members to buy into clinical pathways was difficult in the initial stages of development, but after highlighting the benefits of clinical pathways, they became more receptive to change. Other problems that were faced during the development was the limited use of clinical pathways in the region, the rapidly changing workforce, the cultural/religious need of the patient and varied knowledge base among nursing staff. There were also many advantages to developing pathways in the Middle East; diverse workforce and an ever-changing work environment helped to make clinical pathways at SKMC effective in delivering high standards of care. There are currently nine clinical pathways: surgical, medical and paediatric, and two in development – paediatric acute gastroenteritis and coronary artery bypass grafting. Lengths of stay have been reduced since implementing clinical pathways, some more significant than others. In future months, clinical pathways will be in electronic format and will be known as power plans.