A clinical pathway may be defined as ‘a standardized, prewritten, one-or twopage document showing the interventions of all disciplines along a time schedule. It is a grid, with time as one axis and staff actions as the other’ (Zander, 1995: 9). Clinical pathways were first developed by the nurse Karen Zander and her team of nurses at the New England Medical Center Hospitals in Boston (Garbin, 1995; Hofmann, 1993; Zander, 1995). According to Zander, the idea of clinical pathways soon spread internationally because they were non-conceptual, visually appealing, easy to write and effective in reviewing and decreasing the length of stay of patients in hospitals (Zander, 1995: 11).