What is the type and weight of evidence utilised in measuring the impact of "care pathway technologies" on service integration in stroke care?

Abstract

Objectives 1. To systematically review all high quality studies which have evaluated the effectiveness of care pathway technologies on ‘service integration’ and its derivatives, i.e. seamless care, joined up working etc in stroke care. 2. To examine how elements of service integration are defined in such studies. 3. To examine the type of evidence utilised to measure service integration. 4. To analyse the weight of evidence used to support claims about the impact of care pathways on service integration. 5. To produce guidelines for the users of care pathways and researchers for evaluation purposes. Criteria for considering studies for this review Types of participants This review is concerned with the effects of care pathway technologies on service integration across the spectrum of stroke care and will not be restricted to a particular care setting. Only adult patients will be included in the review. Types of Interventions There is no explicit definition of care pathways in the literature and the problems in describing care pathways are caused by the many similar terms that exist. Examples of synonyms of care pathways include care maps, care protocols, critical paths, collaborative plan of care and multi-disciplinary action plans. For the purpose of this review, a “care pathway technology”, must meet the broad definition set out in the background section. Types of outcome measures Any impact on ‘service integration’ that is attributable to a care pathway technology. Due to the complex nature of service integration, we predict that some of these effects may warrant further unpacking, as the outcomes we are interested in may be embedded within the data. One aim of the review is to contribute to conceptual refinement in this area.