Developing Clinical Pathways

When it comes to patient safety, the best way to be prepared is to develop evidence-based plans and strategies to guide patients through the healthcare system. These plans are called clinical pathways.

Developing Clinical Pathways

Clinical pathways are being developed in hospitals nationwide to help physicians move patients through the hospital. They are designed by the hospital, for the patients, and they have many benefits.

• Reduce risk and variation within patient treatment
• Improve safety and patient outcomes
• Less guess work, less errors
• Reduced duplication of procedures or services
• Educates providers about best practices
• Continuous improvement of care processes

Defining Clinical Pathways

How are clinical pathways defined then? How do hospitals go about setting these pathways and implementing them? Here are some key features:

• A structured, multidisciplinary approach
• Funnels the translation of guidelines to the bedside
• Details the steps of care using a decision tree or other inventory of actions
• Set timeframes and criteria-based progression
• Standardize care for a specific clinical event or episode of healthcare relevant to a certain patient population

Assembling a Team, Improvement Criteria | Clinical Pathways

Clinical Pathways are generally designed either in-house or with the assistance of a consulting company and are typically led by a nurse or other clinician – this person will be the driver of the initiative and will help facilitate effective communication amongst team members. They will also examine which clinical processes may need revamped pathways, and these will be given priorities over other areas in terms of developing pathways. When it comes to selecting these processes for improvement, there are some specific criteria:

• There’s documented variation in current practices
• The variation have adverse impact on safety, clinical outcome or cost
• There is a clinical champion or consensus among clinicians that change is needed
• There is a clear direction for the change to go in
• The changes proposed are achievable
• It’s likely that the improvement will be successful and long-lasting

Framework for Implementation | Clinical Pathways

1. Define the outcomes and timelines
2. Identify the sources of variation – the gap between your current and ideal state
3. Test, test, test! Before you implement
4. Sustain and spread: make the changes available, monitor conformance and make sure to support questions and troubleshooting