Care pathways for pediatric surgical conditions

Care pathways (CPs) are a healthcare process innovation that started in the early 2000s. 1 A CP is an intervention or series of interventions for decision-making and organization of care processes for a well-defined group of patients during a given time window.1 While such pathways do not apply to patients with rare or multiple diseases or those with uncertain treatment durations, in a large volume of patients with a disease diagnosis that is routinely treatable, they can critically impact individuals and populations.2 For instance, a popular example of a CP is (algorithmic) management of cardiovascular arrest by cardiopulmonary resuscitation.3 Typically, when a person collapses suddenly without an apparent cause such as injury or hypoglycemia, healthcare professionals or trained personnel are advised to follow a stepwise protocol involving securing the individual’s immediate surroundings, checking for their breath sounds and pulse, calling for help and informing an ambulance, and initiating chest compression in the absence of breathing and if the pulse cannot be felt. Similarly, CPs during the management of traumatic roadside accidents and injuries rely on the advanced trauma life support protocol, which would involve surveying the injured for life-threatening injuries, controlling external bleeding, airway management, breathing and circulation, and disability/injury management.4 In both examples, these interventions within the CPs applied to well-defined patient groups (cardiac arrest patients or injured persons) during well-defined periods (right after collapse or injury) can enable immediate detection, immediate care, and continued care through defined steps.