Close menu


Sunderland Repository records the research produced by the University of Sunderland including practice-based research and theses.

Implementing online evidence-based care pathways: A mixed-methods study across primary and secondary care

Akehurst, Joy, Sattar, Zeibeda, Gordon, Isabel and Ling, Jonathan (2018) Implementing online evidence-based care pathways: A mixed-methods study across primary and secondary care. BMJ Open, 8 (e02299). pp. 1-11. ISSN 2044-6055

Item Type: Article


Aim To understand what contextual influences, mechanisms and outcomes affect the implementation and use of localised, online care pathways (HealthPathways) in primary and secondary care.

Design and procedure Mixed-measures design. Quantitative data included number of page views and conditions viewed. Qualitative data from semistructured interviews and focus groups were gathered over a 6-month period, and analysed using NVivo software.

Setting The first HealthPathways UK site, South Tyneside, England.

Participants General practitioners, nurses, practice managers, hospital consultants and system leaders (managers, commissioners) (n=76).

Results Use of the pathways significantly increased over time. Themes were developed showing how online care pathways were used—leadership, pre-existing networks and relationships; development of systems and processes for care pathways, the use of online care pathways to support decision-making and referral, and perceived availability of resources. Inter-related themes were arranged into configurations consisting of contextual influences, mechanisms and outcomes. Recommendations were made for future implementations, such as improved data collection processes to understand how and why there was variance in the use of pathways.

Conclusions This study was early in the implementation process; however, emerging themes will facilitate the future implementation and use of online care pathways. Recommendations are made for further research to include other health and social care users and patients to inform future developments.

Akehurst et al BMJO 2018.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial.

Download (495kB) | Preview

More Information

Depositing User: Jonathan Ling


Item ID: 10469
Identification Number:
ISSN: 2044-6055
Official URL:

Users with ORCIDS

ORCID for Joy Akehurst: ORCID iD
ORCID for Jonathan Ling: ORCID iD

Catalogue record

Date Deposited: 11 Mar 2019 11:04
Last Modified: 20 Jan 2023 10:08


Author: Joy Akehurst ORCID iD
Author: Jonathan Ling ORCID iD
Author: Zeibeda Sattar
Author: Isabel Gordon

University Divisions

Faculty of Health Sciences and Wellbeing
Faculty of Health Sciences and Wellbeing > School of Nursing and Health Sciences


Sciences > Health Sciences

Actions (login required)

View Item (Repository Staff Only) View Item (Repository Staff Only)