Optimizing Perioperative Pathways and Critical Care Outcomes: A Systematic Review of Interprofessional Workflows Across Surgical, Respiratory, Intensive Care, and Rehabilitative Services

Background: Perioperative and critical care outcomes depend on coordinated work across surgeons, anesthetists, nurses, respiratory therapists, intensivists, physiotherapists, occupational therapists, dietitians, pharmacists, and rehabilitation teams. Fragmented workflows increase complications, ventilation exposure, delayed mobility, prolonged hospitalization, and poor functional recovery. Objective: This systematic review evaluated interprofessional workflows used across surgical, respiratory, intensive care, and rehabilitative services. Methods: A systematic review was prepared according to PRISMA principles. PubMed, Scopus, Web of Science, and Cochrane sources were searched for original studies addressing adults managed through perioperative pathways, enhanced recovery programs, ICU communication tools, ventilator liberation protocols, early mobility programs, and prehabilitation. Eligible studies reported clinical, functional, respiratory, or process outcomes. Results: Ten original studies were included in the results synthesis. The strongest recurring pattern was that structured team workflows improved process reliability and shortened hospital or ICU exposure when implementation was active, audited, and multidisciplinary. Surgical checklists, ERAS pathways, daily ICU goals, paired awakening and breathing trials, early rehabilitation, and prehabilitation were associated with improved safety, shorter length of stay, greater ventilator-free days, reduced delirium, improved mobility, or fewer complications. Conclusion: Interprofessional pathways are central to ICU improvement. Benefit depends on adherence, team communication, staffing, patient selection, and integration across the preoperative, intraoperative, ICU, ward, and post-discharge phases.