What about care pathways

TLDR: It is stated that healthcare should change and that the purpose of healthcare systems is not to minimize costs but to deliver value for patients, which in the long run results in better health per dollar spent.

Abstract: Porter et al. ( 1 ) stated that healthcare should change and that the purpose of healthcare systems is not to minimize costs but to deliver value for patients, which in the long run results in better health per dollar spent. Three principles should guide this change: (i) delivering value to patients, (ii) medical practice should be organized around medical conditions and care cycles, and (iii) results — risk adjusted outcomes and costs — must be measured. With respect to this change, the role of the multidisciplinary team is to focus on the clinical process innovation (CPI) ( 2 ). CPIs are central to the ability of organizations to negotiate the challenges of cost containment and quality improvement, yet many CPIs have not met expectations to improve these primary processes ( 2 ). Well organized care processes, medical conditions, or care cycles lead to appropriate outcomes if they include a structured context and a well-functioning multidisciplinary team ( 3 ). Patient safety, quality of care, and efficiency of healthcare procedures are international phenomena. In 1991, Brennan et al. ( 4 ) concluded that a substantial amount of injury to patients occurs due to healthcare management and that many injuries result from substandard care processes. One of the most cited reports on this topic was published by Kohn and colleagues of the Institute of Medicine (IOM): To err is human ( 5 ). Later, other authors from all over the world published similar results on adverse events. The first and fundamental ethical principle in healthcare — do no harm — is now being taken seriously by a wide constituency. Five years after the IOM report, in 2004 Altman et al. ( 6 ) concluded that many promising efforts have been launched, but the task is far from complete. Although adverse events are not uncommon in hospitalized patients, they are by no means inevitable ( 7 ). Even if a direct relationship is difficult to establish between variations and errors, reducing variations by standardizing clinical processes is an effective tool to minimize the probability of medical errors ( 5 ).