The intent is good but… Exploring barriers and enablers to clinical pathway use in regional Australian Emergency Departments

Clicks: 5
ID: 329699
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #136 of 144 articles by views in International journal for quality in health care : journal of the International Society for Quality in Health Care

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 144 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
BACKGROUND: Clinical pathways can improve the quality, safety, and efficiency of care, but their integration into routine emergency department (ED) practice remains challenging. Factors influencing pathway use, particularly organisational and contextual determinants, are often overlooked, despite their importance for successful implementation and sustainability. These challenges may be amplified in regional EDs facing workforce and resource constraints. This study examined the barriers and enablers influencing the use of fractured neck of femur (NOF) and suspected stroke pathways in regional Australian EDs to inform service improvement and pathway redesign. METHODS: A qualitative exploratory study was conducted across regional EDs in Tasmania. The study utilised big picture mapping workshops and semi‑structured interviews to examine pathway use in real‑world clinical settings. 25 clinicians participated in three multidisciplinary mapping workshops, and 14 clinicians took part in in‑depth interviews. Mapping identified key steps and decision points within fractured NOF and stroke pathways, while interviews explored clinicians' experiences and perceptions. Data were deductively analysed using the updated Consolidated Framework for Implementation Research (CFIR). RESULTS: Mapping revealed common care processes but significant site-level differences, including inconsistent pathway initiation. Interviews revealed that pathway use was influenced by factors across CFIR domains: complexity and workflow misalignment were barriers, with digital integration a valued enabler (Innovation). Time pressures and resource limitation affected pathway use (Outer Setting). Leadership buy‑in and champions enabled use (Inner Setting). Clinicians expressed concern about diminishing clinical judgment (Individuals domain), while Implementation Process domain barriers included limited collaboration. CONCLUSION: Pathway use in Tasmanian EDs is influenced by barriers and enablers across CFIR domains. Simplifying pathways and ensuring adaptability were perceived to improve usability, while misaligned workflows and paper-based processes hinder uptake. Addressing resource constraints, fostering leadership engagement, and strengthening education are essential. Embedding planning, collaboration, and feedback will ensure pathways remain practical, evidence-based, and deliver timely, standardised care.
Reference Key
openalex_W7214119048 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Innocent Tawanda Mudzingwa, Phoebe Griffin, Emma Tavender, Giles Barrington, Trần Tuấn Việt, Sarah Jane Prior
Journal International journal for quality in health care : journal of the International Society for Quality in Health Care
Year 2026
DOI
10.1093/intqhc/mzag153
URL
https://doi.org/10.1093/intqhc/mzag153
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.