The clinical pathway has become popular since 2014 for psychiatric emergency services in Japan. However, its utilization is still unknown. The Japanese Society for Clinical Pathway created a definition for the clinical pathway in 2014. According to this definition, a clinical pathway must include three methods: (1) setting outcomes, (2) evaluating outcomes, and (3) variance analysis. However, how prevalent these paths containing these three techniques is unclear. Thus, we conducted a questionnaire survey of hospitals with psychiatric emergency departments.
 As a result of the survey, it was found that 49.3% of the hospitals had introduced the pass. However, 61.8% set outcomes, 44.1% evaluated outcomes, and 26.5% conducted a variance analysis. It became clear that pathways that meet the definition of the Japanese Society for Clinical Pathway are not sufficiently popular.
 We considered that two main factors prevent a path that encompasses outcome setting, outcome evaluation, and variance analysis from becoming popular. The first factor is the issue of nurse records. The inputs of outcome setting, outcome evaluation, and variance analysis alone cannot express nurses' observations and thought processes. As a result, there is a problem that the pass cannot include the items required by the nurse. The second factor is the problem with electronic patient record software packages. As a result of the survey, 94.2% of hospitals have introduced electronic patient records. However, few electronic patient record software packages have functions for setting and assessing outcomes and analyzing variances.
 Authors' abstract