Development and implementation of a clinical pathway for gynecologic oncology in a tertiary care hospital in Berlin, Germany

Abstract Aim Standardization in healthcare is essential for high-quality patient care. Despite the proven benefits of clinical pathways, they are still underutilized in clinical practice. This study aimed to develop an explicit evidence-based clinical pathway for gynecologic oncology by translating an existing implicit pathway at a tertiary care hospital in Berlin into an evidence-based, structured process. Subject and methods Semi-structured interviews with 20 healthcare professionals from all relevant disciplines involved in gynecologic oncology were conducted to capture the implicitly followed clinical pathway. Interviews were analyzed using qualitative content analysis. External requirements, including legal regulations and certification criteria, were integrated. The development process was guided by a participatory, interprofessional approach involving all stakeholders. Results The resulting explicit evidence-based pathway includes 26 steps, expanding significantly on the 14 steps of the previously undocumented pathway. Notable additions included pre-therapeutic tumor board discussions, documented preoperative and postoperative consultations, and structured discharge planning. The participatory process fostered alignment with external mandates and improved interprofessional collaboration. The pathway was successfully implemented and will be evaluated after 1 year. Conclusion Transitioning from implicit to explicit evidence-based pathways is a demanding and challenging process, emphasizing stakeholder engagement and information technology support. Financial constraints pose challenges, but initiatives such as quality contracts offer opportunities for resource allocation. This study validates hypotheses, confirming the efficacy of collaboration of involved professionals and integration of external requirements in pathway development. The study underscores the importance of explicitly defined clinical pathways, providing valuable insights for healthcare professionals facing similar challenges, highlighting the need for ongoing evaluation and adaptation. Despite resource challenges, stakeholder collaboration and information technology support are crucial for pathway effectiveness and relevance in evolving healthcare landscapes.