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Book Review: Developing Care Pathways — Handbook (book 1) and Toolkit (book 2)

Book Review: Developing Care Pathways — Handbook (book 1) and Toolkit (book 2) BOOK REVIEW Practical issues, such as how to achieve ‘ownership’ Developing Care Pathways -Handbook (book 1) and and also acknowledging that the plan will never be Toolkit (book 2). perfect and will always be dynamic, are well explained. Kathryn de Luc. Oxford: Radcliffe Medical Press, My only real criticism is that this two-volume 2000. ISBN 1 85775 499 9 (for both Handbook and book is almost entirely process oriented. That is to Toolkit), A30.00 (for both). say, great detail is provided on how a pathway could When was the last time you started reading a textbook be set up, but there is scant discussion of why path- and found that you couldn’t put it down? Well, this ways are needed in the first place. No practical one, although not quite that compelling, was certainly examples of improvements in outcome (effective- an enjoyable read. ness) are discussed, and cost-effectiveness is never This two-volume book introduces itself as being nieiitioned. Other literature is referred to which written for organisations wishing to develop care would provide those details but simplified extracts pathways, and I believe it would give them the could have been included. I would have liked to knowledge and confidence to decide whether they have seen some real examples of improvements in wished to proceed. De Luc writes with a clear style care, or at least documented improvements in inter- and demystifies the entire process. As a novice to this disciplinary communication. The pathways approach arena, I found that the steps towards pathway devel- is intellectually appealing but that is not sufficient in opment were concise and presented in a logical order. the modern era. The first volume, called the ‘Handbook’, defines a There is a fair amount ofjargori in this book but all care pathway and then works through, in a stepwise abbreviations are referenced at least once, so the text fashion, the processes involved in establishing one. A can be followed. As with a11 specialities, workers in separate chapter addresses legal aspects and issues of pro- this field should be aware that they are not using a uni- fessional accountability. Another chapter uses some fre- versal language and should take extra care in a book quently encountered questions to clarify the process. aimed at professionals outside of this new speciality. The second volume, the ‘Tool Kit’, is much more There are also a couple of technical issues which practical and concerns itselfwith the actual steps involved are introduced in a tantalising fashion and then in developing integrated care pathways. This includes never really explained - for example, what is the discussion of the personnel needed, the numbers of ‘80:20 rule’? meetings required, the nature of the documentation and In summary, I am impressed by this book and after how deviations from the basic pathway (variances) reading it feel that I have an overview of how a care should be documented and considered further. pathway could be developed. I am also left with some Anticipated problems in establishing and imple- of the enthusiasm that the author obviously feels for menting pathways are discussed in a pro-active fash- her subject. However, there is no real discussion of ion. For example, it is acknowledged that doctors may how care pathways are beneficial in terms of outcome feel a loss of decision-making flexibility or even a loss and, for me, that significantly restricted the usefulness of professional autonomy if patients are treated identi- of this otherwise excellent book. cally. However, it is explained that all professional decisions would still be acceptable, and if they varied Sue Levi MBBChir, MRCP, DTM&H, MRCGP from the standard pathway they could be recorded Specialist Registrar in Pirlrlic Health as East Kent Health Airtlzority variances from that pathway and could retrospectively Dover, UK be analysed. JOUILNAL OF INTEGILATED CAKE PATHWAYS (2001) 5, 105 0 Tlic Kcigol Soiktg ofMrdiiirrc Prms 2001 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Integrated Care Pathways SAGE

Book Review: Developing Care Pathways — Handbook (book 1) and Toolkit (book 2)

Journal of Integrated Care Pathways , Volume 5 (2): 1 – Aug 1, 2001

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Publisher
SAGE
Copyright
© 2001 SAGE Publications
ISSN
1473-2297
DOI
10.1177/147322970100500208
Publisher site
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Abstract

BOOK REVIEW Practical issues, such as how to achieve ‘ownership’ Developing Care Pathways -Handbook (book 1) and and also acknowledging that the plan will never be Toolkit (book 2). perfect and will always be dynamic, are well explained. Kathryn de Luc. Oxford: Radcliffe Medical Press, My only real criticism is that this two-volume 2000. ISBN 1 85775 499 9 (for both Handbook and book is almost entirely process oriented. That is to Toolkit), A30.00 (for both). say, great detail is provided on how a pathway could When was the last time you started reading a textbook be set up, but there is scant discussion of why path- and found that you couldn’t put it down? Well, this ways are needed in the first place. No practical one, although not quite that compelling, was certainly examples of improvements in outcome (effective- an enjoyable read. ness) are discussed, and cost-effectiveness is never This two-volume book introduces itself as being nieiitioned. Other literature is referred to which written for organisations wishing to develop care would provide those details but simplified extracts pathways, and I believe it would give them the could have been included. I would have liked to knowledge and confidence to decide whether they have seen some real examples of improvements in wished to proceed. De Luc writes with a clear style care, or at least documented improvements in inter- and demystifies the entire process. As a novice to this disciplinary communication. The pathways approach arena, I found that the steps towards pathway devel- is intellectually appealing but that is not sufficient in opment were concise and presented in a logical order. the modern era. The first volume, called the ‘Handbook’, defines a There is a fair amount ofjargori in this book but all care pathway and then works through, in a stepwise abbreviations are referenced at least once, so the text fashion, the processes involved in establishing one. A can be followed. As with a11 specialities, workers in separate chapter addresses legal aspects and issues of pro- this field should be aware that they are not using a uni- fessional accountability. Another chapter uses some fre- versal language and should take extra care in a book quently encountered questions to clarify the process. aimed at professionals outside of this new speciality. The second volume, the ‘Tool Kit’, is much more There are also a couple of technical issues which practical and concerns itselfwith the actual steps involved are introduced in a tantalising fashion and then in developing integrated care pathways. This includes never really explained - for example, what is the discussion of the personnel needed, the numbers of ‘80:20 rule’? meetings required, the nature of the documentation and In summary, I am impressed by this book and after how deviations from the basic pathway (variances) reading it feel that I have an overview of how a care should be documented and considered further. pathway could be developed. I am also left with some Anticipated problems in establishing and imple- of the enthusiasm that the author obviously feels for menting pathways are discussed in a pro-active fash- her subject. However, there is no real discussion of ion. For example, it is acknowledged that doctors may how care pathways are beneficial in terms of outcome feel a loss of decision-making flexibility or even a loss and, for me, that significantly restricted the usefulness of professional autonomy if patients are treated identi- of this otherwise excellent book. cally. However, it is explained that all professional decisions would still be acceptable, and if they varied Sue Levi MBBChir, MRCP, DTM&H, MRCGP from the standard pathway they could be recorded Specialist Registrar in Pirlrlic Health as East Kent Health Airtlzority variances from that pathway and could retrospectively Dover, UK be analysed. JOUILNAL OF INTEGILATED CAKE PATHWAYS (2001) 5, 105 0 Tlic Kcigol Soiktg ofMrdiiirrc Prms 2001

Journal

Journal of Integrated Care PathwaysSAGE

Published: Aug 1, 2001

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