The development of the gynecologic oncology pathway "VivaPathway GT" - a qualitative study about the transformation from an implicit to an explicit, evidence-based clinical pathway in a Berlin-based tertiary care hospital

IntroductionStandardization in healthcare is crucial for comprehensive patient care, as emphasized by the WHO and quality management principles. Clinical pathways offer a structured approach to describing essential processes, particularly relevant in gynecologic oncology care. Despite their proven benefits, pathways remain underutilized, highlighting the need for explicit translation of implicit pathways. Materials and MethodsThis study employed semi-structured interviews with healthcare professionals to capture implicit gynecologic oncology pathway. Interviews were examined using qualitative content analysis. External requirements, legal mandates, and certification criteria were integrated into pathway development. A participatory approach involving interprofessional collaboration guided pathway refinement. ResultsThe study applied the Pathway Associations 7-phase method, illustrating the development of VivaPathway GT. The explicit pathway, enriched with external requirements, comprised 26 steps, enhancing comprehensiveness and interprofessional involvement. Notable additions included pre-therapeutic tumor boards and detailed post-operative consultations. DiscussionTransitioning from implicit to explicit pathways is a is a demanding and challenging process emphasizing stakeholder engagement and IT support. Financial constraints pose challenges, but initiatives like quality contracts offer opportunities for resource allocation. The study validates hypotheses, confirming the efficacy of collaboration of involved professionals and integration of external requirements in pathway development. ConclusionsThis study underscores the importance of explicit clinical pathways. It provides valuable insights for healthcare professionals facing similar challenges, emphasizing the need for ongoing evaluation and adaptation. Despite resource challenges, stakeholder collaboration and IT support are crucial for pathway effectiveness and relevance in evolving healthcare landscapes.