Barrier and Enabler of Clinical Pathway Implementation in Hospital: A Systematic Review

Indiraya Adisandiya, Mieke Savitri


Health Policy Administration, Faculty of Public Health, Universitas Indonesia



Background: While clinical pathways have the potential to improve patient outcome and reduce healthcare cost, their true impact has been limited by variable implementation strategies and suboptimal research. In this review author will explain about barrier and enabler of clinical pathway implementation in hospital.

Subjects and Methods: A systematic review was conducted by searching the following databases included PubMed, ProQuest, Google scholar, Directory Open Access Journal (DOAJ), and “grey” journals which published articles from 2014 to July 2016.

The keyword for this review was barriers and enablers related to clinical pathways implementation. The inclusion criteria were review, systematic review, clinical review and guidelines. After review process 14 articles were included in this review.

Results: All studies results categorize barriers of clinical pathways into 4 factors included (1) clinician knowledge, (2) familiarity, (3) attitude, (4) workload factors. Factors that enablers of clinical pathways implementation included (1) team dynamics, (2) clinical pathway as a tools and standardization, (3) quality and process improvement. Conclusion: Good team collaboration, understanding of the clinical staffs, improvement of the quality of services and ongoing monitoring to maintain determine the sucessful implementation of the clinical pathways.

Keywords: barriers, enablers, clinical pathways, clinical care, hospital

Correspondence: Indiraya Adisandiya. Health Policy Administration, Faculty of Public Health, Universitas Indonesia. Email: Mobile: 085814970769.


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