How Clinical Pathways are Leading Us Towards Patient-Centered Care
America’s medical community is beginning to implement a revolutionary strategy for patient treatment — one that many hope will greatly reduce errors, shorten patient admission time, decrease the rates of readmittance, and empower patients to take part in the treatment process. This strategy utilizes “clinical pathways.”
Definition of “Clinical Pathways”
A “clinical pathway,” similar to a nursing care plan, outlines concrete protocols for responding to patient needs. Nurses who routinely treat the same maladies can, and often do, perform treatment procedures from memory. However, as Dr. Kenneth Silverstein aptly stated in “Focus,” a Christiana Care Health System (CCHS)publication, “We don’t have the luxury to fail in this business. In a high-stakes environment, you want to have prompts so that you’re not missing anything. You don’t want to rely on memory.” A clinical pathway outlines elements such as evaluation methods and algorithms, procedural steps for treatment, and resources for patient and family education as well as recommendations for follow-up and post-care evaluation. The hope behind developing clinical pathways is that they will enhance and increase treatment effectiveness and consistency of care while decreasing the occurrence of mistakes.
Areas Where Clinical Pathways Will Be Utilized
Clinical pathways could be applied to a wide array of medical conditions and resulting procedures and are being developed all over the United States by a spectrum of medical care centers. An example includes the nine debut pathways that are in the process of being installed within various health arenas at the Christiana Care Health System. The CCHS plans to develop one clinical pathway in each of nine different medical categories treated within their group and plan to expand this initial collection of pathways into a much larger resource over the coming years.
- Women and Children’s Health: The initial clinical pathway within the areas of women’s and children’s health will provide a framework for treating gestational diabetes.
- Surgical Services: Within the surgical service line, the first clinical pathway will outline a recurring ventral hernia abdominal wall reconstruction procedure.
- Neurosciences: The neurosciences clinical pathway will deal with acute ischemic stroke.
- Primary Care and Community Health: This service line’s clinical pathway will detail treatment protocol for Type 2 diabetes.
- Musculoskeletal Health: This clinical pathway will detail how to treat vertebral fragility fractures.
- Heart and Vascular Health: The subject of this clinical pathway will be non-ST-segment elevation myocardial infarction.
- Cancer: CCHS’s first cancer clinical pathway details operable Stage 2 non-small-cell lung cancer.
- Behavioral Health: Opioid addiction will be the subject of the behavioral health division’s pathway.
- Acute Medicine: This clinical pathway will assist with the treatment of chronic obstructive pulmonary disease.
This array of conditions and ailments provides an idea of the variety of clinical pathways being developed in today’s medical arena.
The Intersection of Clinical Pathways and Patient-Centered Care
As patient care becomes more standardized, some skeptics might point out that clinical pathways could increase automation and depersonalization within the health care system. What if the checklists and protocols remove room for personal care and the intuition of a human medical professional? However, many medical professionals are optimistic that clinical pathways will enhance the effectiveness of nurses and other medical care providers as they treat their patients and will give them guidance and protection from errors without stifling their quality of personalized patient care. Even opinions that question clinical pathways acknowledge that “utilization of clinical pathways, in which an individual’s treatment follows a defined protocol, can help ensure patients receive the best possible care based on the most recent scientific data.” And an amount of variability will always be part of the process: “For clinical pathways to be most effective, they need to accommodate many external factors impacting patients.” When clinical pathways are developed in such a way that allow medical professionals to tailor each patient’s treatment plan to the unique elements of the individual case, clinical pathways could greatly enhance the quality of medical care provided in the United States.
A goal and anticipated result of using clinical pathways is a reduction in readmitted patients, a shorter average treatment time period by streamlining treatment and avoiding unnecessary or extraneous steps, and a higher rate of successful treatments. In addition, part of the goal for clinical pathways is that they better involve the patient in their own treatment by incorporating self-care, robust follow-up, and better educational protocols that enable the patient to contribute to the treatment process. This includes connecting patients with resources outside the hospital that could aid them in their recoveries or treatment processes, like gyms, health centers, classes, seminars, pharmacists, specialists, or holistic treatment providers.
As clinical pathways are adopted and improved by a growing number of medical centers and providers, hopes are high that they will enhance the level and quality of care provided to patients across the United States. Medical professionals across the country are working hard to develop clinical pathways that could impact countless patients.
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