Clinical pathways are not a new concept. They were developed in the 1980s, and like skinny jeans and mini skirts, this trend in patient care has been in and out of fashion over the decades. Today as we transition to value-based payment models, clinical pathways are again in vogue and increasingly employed to reduce variability in care and contain costs.
Wait, what are common clinical pathways?
Clinical pathways are standardized care plans based on clinical best practices for specific diagnoses. Each pathway provides guidance on a recommended sequencing of steps to make decisions and treat patients. In the post-acute care continuum, the following diagnoses lend themselves well to pathway programs:
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Why are there mixed opinions about clinical pathways?
With certain trends in fashion, like shoulder pads in women’s clothes, there are no mixed opinions. We all agree that shoulder pads are clunky, unflattering, and just plain weird, right?!
However, with clinical pathways opinions vary. Critics of clinical pathways believe this approach lacks personalization, pigeon-holes patients in the attempt to control costs, and may hinder patients’ access to effective treatments that don’t fit within the pathway.
Advocates on the other hand believe that this approach reduces errors, lengths of stay, and costs, while increasing efficiency and quality. Supporters also feel that clinical pathways can lead to fewer complications and re-hospitalizations.
As health care leaders, can clinical pathways help us do it all – reduce costs, increase quality, and satisfy patients?
We believe the answer is YES – if designed and implemented correctly, clinical pathways can enable person-centered care that is tailored to each patient’s needs and allows for variations and customizations based on each person’s unique circumstances. Design of each pathway must encompass the entire care continuum – from diagnosis through treatment, discharge planning, and ongoing monitoring. Consistency and communication are keys to success.
What should your team consider as you design clinical pathways?
Here are some questions to discuss with your team as you design and improve upon clinical pathways in your facility or community:
- Which disciplines should be included in the process – nursing, therapy, diagnostics, pharmacy, nutrition – who else?
- What input do we need from hospitals and physicians who trust us to take care of their patients? What protocols or guidelines do they already have in place?
- How will we collaborate with home care and other providers after patients leave our facility?
- What if patients need “off-pathway” treatments? How will we know and what will we do?
- Regarding therapy for each pathway, how will we optimize the number of therapy visits and reduce the variability in therapy services?
- What processes will we employ to make sure the entire team understands each pathway? What education do we need to put in place for staff?
- How will we ensure that patients feel fully informed and involved? (Otherwise, patients may feel that these pathways are just intended to steer them to a limited range of treatment options preselected by their insurance provider.) What education do we need to develop and conduct with patients to encourage compliance and autonomy, so they are empowered to take part in their own treatment?
- How will we measure quality and outcomes with each pathway? What standards, benchmarks, and patient experience metrics should be put in place? And how will we iterate and improve upon our performance over time?
It seems like this time around clinical pathways are here to stay – less like hair crimping (remember that funny fad?!) and more like that perfect white button-down shirt that is always in style. When they are employed across the full continuum of care, these pathways can help your organization more consistently manage care and achieve the best possible patient outcomes.
As your team develops clinical pathways, if you feel you need guidance from a therapy perspective, our team is here and ready to help. Contact us at 248-349-9595 or email carrie@therapy-management.com.
Therapy Management, Inc. supports patients in their overall journey by providing inpatient therapy, outpatient therapy, and home care. We deliver person-centered therapy services, compliance expertise, business intelligence, and analytics to senior communities who want to gain competitive advantage in a crowded marketplace.
