An integrated care pathway (ICP, also called a clinical pathway or care pathway) is a structured, multidisciplinary plan that maps out the expected sequence of clinical care for a patient with a particular condition, from admission through to discharge and beyond. The pathway sets out what should happen at each stage, who is responsible, what the expected outcomes are, and how progress is documented. The aim is to bring together all the information from different members of the clinical team into a coordinated, consistent approach that reduces unnecessary variation and helps ensure best practice is followed.
In the context of cardiac arrest, formal care pathways guide the management of patients from the moment of resuscitation through to intensive care, step-down care, and ultimately discharge planning and follow-up. Key elements of a post-cardiac arrest care pathway typically include immediate post-resuscitation stabilisation, coronary angiography if a cardiac cause is suspected, targeted temperature management (TTM) or controlled normothermia, neurological prognostication, ICD assessment and implantation, and referral to cardiac rehabilitation.
Integrated care pathways serve several purposes. They support junior staff and those less familiar with a specific condition by providing clear guidance at each decision point. They facilitate audit and quality improvement by creating a record that can be compared against the expected standard. They also improve communication between specialties and between hospital and community services, reducing the risk of important steps being missed during transitions of care.
In the broader NHS context, integrated care systems (ICSs) and integrated care boards (ICBs) are now the structural vehicle for commissioning and planning health and care services across a locality, replacing the previous clinical commissioning groups. The emphasis on integration reflects a recognition that many patients, including cardiac arrest survivors with complex physical and psychological needs, benefit most from services that communicate and coordinate effectively across hospital, primary care and community settings.
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