Exploring the integrative effect of care pathway practices and their impact on patient flow in Norway: a multiple case study

Abstract Background This study investigates care pathway practices and their impact on patient flow in Norwegian hospitals. Care pathways, which aim to enhance the efficiency and quality of patient care, are increasingly implemented to address the growing demand and resource constraints in healthcare systems. Despite their increasing adoption, the mechanisms through which care pathways influence patient flow remain underexplored. Methods This research employs a multiple case study approach, examining colorectal and prostate cancer care pathways across three hospitals. Through 35 semi-structured interviews, the study explores how fifteen care pathway practices recognised in literature foster integration and their effects on patient flow. Results Findings reveal that care pathway coordinators play a crucial role in reducing non-value-added activities and bottlenecks; however, challenges remain in leveraging real-time data and extending the planning horizon beyond operational level. While care pathway practices have the potential to foster integration and improve patient flow, their effectiveness depends on how they are operationalized and the specific contextual factors of each hospital. Conclusions The study contributes to the theoretical understanding of patient flow in healthcare by exploring how specific care pathway practices stimulate cross-department integration within the aspects of organizational, planning and control, and information flow. Future research should study a larger set of cases and potentially explore additional practices that are applied in care pathways.