What is protocol-based care? A concept analysis.

Aim: To define protocol-based care to make this way of delivering health care amenable to theoretical and empirical studies.

Background: Although protocol-based care is associated with the evidence-based practice and standardization movements, it is an ill-defined and understood concept.

Method: A multiphase concept analysis, inspired by an evolutionary view was used to clarify 'what is protocol-based care'. The inductive, five-phase process drew upon content analysis of policy documents and the literature, plus interviews with a purposive sample of 35 opinion leaders.

Results: The term was used interchangeably with protocols, pathways and guidelines in policy and guidance documents. A search of seven databases produced only 57 references to protocol-based care. The concept analysis revealed a continuum of scope and specificity and also distinguished specialist and generic applications of protocol-based care.

Conclusions: Managers need to take cognizance of the significance and complexity of protocol-based care when introducing this way of working.