General surgical clinical pathways: an introduction.

With increasing pressures to reduce the cost of health care, protocols and practice guidelines are being developed to streamline the practice of medicine. Many of these guidelines have been developed by health care workers who are not involved in the daily care of patients and who do not have clinical expertise in the specific diseases. The Southeastern Surgical Congress appointed a committee to develop clinical pathways for common surgical diseases. These clinical pathways have been developed by practicing surgeons with expertise in common surgical diseases and reviewed for their applicability by other surgeons with clinical expertise. The types of guidelines are reviewed and the need for guidelines are discussed. This paper presents the purpose, development, essential elements, and the dissemination and implementation of clinical pathways for common surgical diseases. It is critical that surgeons and surgical organizations participate in developing clinical guidelines and clinical pathways.