What is a clinical pathway?
A clinical pathway is a process that is designed to provide optimal, evidence-based, individualized care for a patient with specific condition or disease. The goal of a clinical pathway is to provide optimal health and an exceptional health care experience, while reducing unnecessary variation in care. When properly applied, clinical pathways help to improve quality and safety of care while potentially reducing the cost of care.
Clinical pathways are not unique to Christiana Care Health System. In other organizations, they are sometimes referred to as care pathways or care process models.
What are the clinical pathways on this website?
In 2015, Christiana Care began a new, formalized process through its nine service lines to develop clinical pathways and apply them in a focused way. The pathways on this website are the result of that effort, and this library of clinical pathways will continually grow and evolve over time. The pathways on this website are kept up-to-date by their respective service lines, and they are presented here for easy reference by clinicians and care providers.
Are these clinical pathways intended to be viewed by patients and consumers?
The clinical pathway documents on this website are designed as reference tools for clinicians, but recognizing that many of our patients and consumers are savvy and interested in understanding more about their health care, we have made them accessible to everyone on this website.
As a clinician or care provider, what’s the best way to talk about clinical pathways with my patients?
“Clinical pathway” is a term that is well understood by many clinicians, but to consumers, including patients and their families, it can sound like medical jargon. From conversations and feedback from Christiana Care’s Patient and Family Advisory Council, which includes more than 180 former patients and family members, we know that in general, “clinical pathway” isn’t a term that patients find engaging.
A more familiar — and meaningful — way to explain a clinical pathway to patients and their families is to use the term “individualized care plan.” This term gets at the heart of why we use clinical pathways: to provide optimal care tailored to each patient’s specific health condition.
Each patient’s individualized patient care plan establishes the expectations for their treatment. By establishing expectations, we help patients and their families to understand what to expect, why it’s the appropriate course of action, when it will happen and what their role is in managing their health. This understanding can help to ease anxiety and promote effective partnerships among care providers, patients and families.
Collaboratively develop goals of care with the patient and family. These goals should include aspirational goals (e.g. attending my son’s wedding), as well as discharge planning goals, as appropriate.
Good communication: procedural pathway
1. Explain who will be involved in the procedure and their role.
2. Discuss timeframe and note any potential delays. Establish a plan for communicating delays.
3. Target known experience gaps, from data and patient focus group comments. Establish expectations specific to each (i.e. postoperative pain, expected discharge date, expected medications at discharge).
4. Provide written education materials to support conversations and serve as reference, including a contact for questions.
5. Set expectations for continued communication: When will be the next time you will speak? How can they reach out with questions?
Good communication: diagnosis pathway
1. Collaboratively develop goals of care with the patient and family.
2. Discuss expected timeframe for treatments and follow-up among varied providers/specialists/adjunct therapies. Note any potential delays/alterations in trajectory. Establish a plan to communicate changes.
3. Provide written education materials to support conversations and serve as reference, including a contact for questions.
4. Establish communication plan to provide continuity of care between consultants and primary care.
6. Target known experience gaps, from data and patient focus group comments. Establish expectations specific to each (e.g.. specialist access, unable to complete adjunct treatment).