Appl Clin Inform 2015; 06(04): 650-668
DOI: 10.4338/ACI-2015-05-RA-0054
Research Article
Schattauer GmbH

A Method to Evaluate Critical Factors for Successful Implementation of Clinical Pathways

W. Dong
1  Cardiology Department, Chinese PLA General Hospital, Beijing, China
Z. Huang
2  College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
› Author Affiliations
Further Information

Publication History

received: 11 May 2015

accepted in revised form: 13 September 2015

Publication Date:
19 December 2017 (online)


Objective: Clinical pathways (CPs) have been viewed as a multidisciplinary tool to improve the quality and efficiency of evidence-based care. Despite widespread enthusiasm for CPs, research has shown that many CP initiatives are unsuccessful. To this end, this study provides a methodology to evaluate critical success factors (CSFs) that can aid healthcare organizations to achieve successful CP implementation.

Design: This study presents a new approach to evaluate CP implementation CSFs, with the aims being: (1) to identify CSFs for implementation of CPs through a comprehensive literature review and interviews with collaborative experts; (2) to use a filed study data with a robust fuzzy DEMATEL (the decision making trial and evaluation laboratory) approach to visualize the structure of complicated causal relationships between CSFs and obtain the influence level of these factors.

Participants: The filed study data is provided by ten clinical experts of a Chinese hospital.

Results: 23 identified CSF factors which are initially identified through a review of the literature and interviews with collaborative experts. Then, a number of direct and indirect relationships are derived from the data such that different perceptions can be integrated into a compromised cause and effect model of CP implementation.

Conclusions: The results indicate that the proposed approach can systematically evaluate CSFs and realize the importance of each factor such that the most common causes of failure of CP implementation could be eliminated or avoided. Therefore, the tool proposed would help healthcare organizations to manage CP implementation in a more effective and proactive way.