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Book Review: Susan Johnson, Ed. Pathways of Care

Book Review: Susan Johnson, Ed. Pathways of Care MANAGED CARE BOOK REVIEW Susan Johnson, ed. Pathways of Care. paediatrics and accident & emergency medicine. Oxford: Blackwell Science, 1997. Unfortunately, many of these and subsequent chapters ISBN 0-632-040-769 (pbk) 2H8pp, £14.99. repeated the explanation and concept of pathways of ca.re. and the potential benefits of its incorporation into With the recent changes in the health service, and the clinical practice. Most of these issues are well discussed increasing financial pressures currently experienced by in t~e first part of the book and make for repetitive those both purchasing and providing health care, this reading when duplicated throughout other chapters. book on pathways of care will come as a welcome Tl~e third part demonstrates the usc of pathways of guide in what is currently an extremely confused area. care 1I1 the non-acute setting and the chapters on The book is edited by Sue Johnson who was initially 'Hospital at Home' and 'Care of patients suffering involved as a facilitator for the integrated care path­ from stroke' were extremely well written. ways set-up in Ashford Hospital, Middlesex, indeed T~e book finishes with the fourth part which the vast majority of the contributors in the book have cxarnmes o.ther issues of implementing pathways of be~n associated either with Ashford Hospital, care including the law, risk management, evidence­ MIddlesex or the surrounding Hounslow and based contracting and automation of pathways. The Spclthorne Area Health Authority. I have to admit ~hapter examining the legal aspects of clinical guide­ that the concept of integrated pathways of care was a lines and pathways of care provided excellent data on subject abo~t whi~h r knew very little before being the signifi.cant improvement this process has brought asked to review this book. To someone like myself it to the delivery of care in certain clinical situations. As would appear that pathways of care involve clinical mentioned earlier, a large part of this chapter would audit, protocols of management and guidelines, be better placed earlier in the book when the concept together in one process facilitating increased effi­ of pathways of care is discussed. One of the major ciency, better quality and hopefully more appropriate messages from this chapter involves the need for a usc of resources in the delivery of health care. th~ro~gh li~erature review before setting up the The first part of the book introduces the concept of guidelines mvolved in the pathways of care. pathways of care, along with the analysis of variation Unfortunately, this aspect is not mentioned in the ~rom the pathway, which is an important part of audit­ ~najority, of the other chapters and obviously has legal mg the pathway and allowing for iterative change as nn?hc~tlOns regarding the accuracy of any clinical appropnate. r was disappointed in the lack of data b'1lldelmes which arc produced by providers of health provided in this section to show the value of care. integrated care pathways for clinical management. If In general this book is readable, informative and this form of delivery of health care is going to be will be extremely useful for all those involved in introduced in a broader setting, both purchasers and organizing and delivering health care in addition to providers are entitled to ask for evidence of validation. those groups involved in contracting and purchasing. Indeed there is an excellent chapter later in the book ~though t~e use of pathways of care in specific reviewing pathways of care, clinical guidelines and the clinical S~~tl~gs is well described in this book, my associated legal implications, when data in support of major criticism IS that no strong data are provided this type of health care delivery are provided, demon­ Wlt~ ~hich those, involved in health care can justify strating significant improvements in certain areas of their m:plementatlon in the clinical setting. As there health care following the introduction of guidelines. It are o~vlOusly data available which do support this type would have been very useful if this information had of delivery of health care, their incorporation into this been presented earlier on in the book. book would be particularly welcome for those who The second part of the book describes how these support this concept and its undoubted future role in patl~ways of care can be used in the acute setting. I the delivery of health care in the United Kingdom. particularly enjoyed the chapter on pathways in urology, which provided striking evidence on the Simon Paterson-Brown improved management of patients undergoing Consultant Su~~eorl ~ransurethral resection of the prostate following the Royal b~firmary introduction of an integrated pathway of care. Similar Lauriston Place pathways are described in cardiology, orthopaedics, Edi'1bu~~h EH3 9YVV; UK JOURNAL OF MANAC;EIJ CARE (1')')7) I, 1l5 ) H""."",I'"'I""i,,,,,,1 Lu! http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Managed Care SAGE

Book Review: Susan Johnson, Ed. Pathways of Care

Journal of Managed Care , Volume 1 (3): 1 – Sep 1, 1997

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Publisher
SAGE
Copyright
© 1997 SAGE Publications
ISSN
1363-9595
DOI
10.1177/136395959700100309
Publisher site
See Article on Publisher Site

Abstract

MANAGED CARE BOOK REVIEW Susan Johnson, ed. Pathways of Care. paediatrics and accident & emergency medicine. Oxford: Blackwell Science, 1997. Unfortunately, many of these and subsequent chapters ISBN 0-632-040-769 (pbk) 2H8pp, £14.99. repeated the explanation and concept of pathways of ca.re. and the potential benefits of its incorporation into With the recent changes in the health service, and the clinical practice. Most of these issues are well discussed increasing financial pressures currently experienced by in t~e first part of the book and make for repetitive those both purchasing and providing health care, this reading when duplicated throughout other chapters. book on pathways of care will come as a welcome Tl~e third part demonstrates the usc of pathways of guide in what is currently an extremely confused area. care 1I1 the non-acute setting and the chapters on The book is edited by Sue Johnson who was initially 'Hospital at Home' and 'Care of patients suffering involved as a facilitator for the integrated care path­ from stroke' were extremely well written. ways set-up in Ashford Hospital, Middlesex, indeed T~e book finishes with the fourth part which the vast majority of the contributors in the book have cxarnmes o.ther issues of implementing pathways of be~n associated either with Ashford Hospital, care including the law, risk management, evidence­ MIddlesex or the surrounding Hounslow and based contracting and automation of pathways. The Spclthorne Area Health Authority. I have to admit ~hapter examining the legal aspects of clinical guide­ that the concept of integrated pathways of care was a lines and pathways of care provided excellent data on subject abo~t whi~h r knew very little before being the signifi.cant improvement this process has brought asked to review this book. To someone like myself it to the delivery of care in certain clinical situations. As would appear that pathways of care involve clinical mentioned earlier, a large part of this chapter would audit, protocols of management and guidelines, be better placed earlier in the book when the concept together in one process facilitating increased effi­ of pathways of care is discussed. One of the major ciency, better quality and hopefully more appropriate messages from this chapter involves the need for a usc of resources in the delivery of health care. th~ro~gh li~erature review before setting up the The first part of the book introduces the concept of guidelines mvolved in the pathways of care. pathways of care, along with the analysis of variation Unfortunately, this aspect is not mentioned in the ~rom the pathway, which is an important part of audit­ ~najority, of the other chapters and obviously has legal mg the pathway and allowing for iterative change as nn?hc~tlOns regarding the accuracy of any clinical appropnate. r was disappointed in the lack of data b'1lldelmes which arc produced by providers of health provided in this section to show the value of care. integrated care pathways for clinical management. If In general this book is readable, informative and this form of delivery of health care is going to be will be extremely useful for all those involved in introduced in a broader setting, both purchasers and organizing and delivering health care in addition to providers are entitled to ask for evidence of validation. those groups involved in contracting and purchasing. Indeed there is an excellent chapter later in the book ~though t~e use of pathways of care in specific reviewing pathways of care, clinical guidelines and the clinical S~~tl~gs is well described in this book, my associated legal implications, when data in support of major criticism IS that no strong data are provided this type of health care delivery are provided, demon­ Wlt~ ~hich those, involved in health care can justify strating significant improvements in certain areas of their m:plementatlon in the clinical setting. As there health care following the introduction of guidelines. It are o~vlOusly data available which do support this type would have been very useful if this information had of delivery of health care, their incorporation into this been presented earlier on in the book. book would be particularly welcome for those who The second part of the book describes how these support this concept and its undoubted future role in patl~ways of care can be used in the acute setting. I the delivery of health care in the United Kingdom. particularly enjoyed the chapter on pathways in urology, which provided striking evidence on the Simon Paterson-Brown improved management of patients undergoing Consultant Su~~eorl ~ransurethral resection of the prostate following the Royal b~firmary introduction of an integrated pathway of care. Similar Lauriston Place pathways are described in cardiology, orthopaedics, Edi'1bu~~h EH3 9YVV; UK JOURNAL OF MANAC;EIJ CARE (1')')7) I, 1l5 ) H""."",I'"'I""i,,,,,,1 Lu!

Journal

Journal of Managed CareSAGE

Published: Sep 1, 1997

There are no references for this article.