The Leuven Clinical Pathway Compass

A vast amount of literature exists on clinical pathways. When reviewing literature from 2000-2002 on Medline, 597 articles about 'clinical pathways' were found. Only 22% of these articles included outcome indicators.' The majority of the articles described how the pathway was developed. Therefore, there is a clear lack of articles evaluating the impact of the clinical pathway. Moreover, there is very little known about the definition and the implementation of a clinical pathway. The pathway itself can have a very high standard, but when it is followed by a loose implementation process, with a very low degree of acceptance by the clinicians, or a low degree of impact in the organisation, the results can be very poor. The narrative way that most of the clinical pathways are described and introduced, leads to many ambiguous results in the implementation of clinical pathways.2,3 Maybe it could be related to the real impact of clinical pathways, but it could also be a result of the quality of the evaluation process. 'If you can't measure it, you can't manage it.'This old management phrase still rings true, especially in clinical m e d i ~ i n e . ~ When we use this saying for clinical pathways, the rigorous evaluation of the implementation of the clinical pathway by means of preand post-tests is a bare necessity. This evaluation