ABSTRACT
Ethos of care pathways Currie and Harvey (2000)1 make the point that care pathways (also called critical paths, clinical pathways, care tracks, integrated care pathways [ICPs], care maps) are being introduced in many healthcare systems around the world with the aim of improving the quality of healthcare. Harkleroad et al. (2000)2 point out that the concept of care pathways borrows much from the theories of continuous quality improvement
(CQI), and as Johnson (1997)3 argues, in order for a CQI programme to be successful it is essential for all staff who are involved in seeing patients to receive feedback on the analyses of care so that they can see if they are performing against expected standards and guidelines and how they might continue to improve. Ahgren (2001 )4 argues that over the past two decades there has been an acceleration of sub-specialisation in healthcare as medical science and technology have progressed. This has led to a fragmentation of the healthcare system, making collaboration and communication between healthcare personnel very difficult when viewed from the horizontal perspective of the patient's journey. The need to develop seamless services tailored to patients' needs rather than how the healthcare organisations are structured has been recognised in The NHS Plan (2000),5 and various NHS National Service Frameworks (NSFs) (2000)6 (2001)/ which set standards of healthcare across the NHS. In the United States (US) this requirement to develop patient-focused, seamless care is referred to as an integrated delivery system.
