Clinical pathways aim to standardize care for a specific clinical problem, process, procedure, or episode in a defined population.
Pathways are structured plans of care that translate guidelines and/or evidence into localized infrastructure and processes. Each pathway details care in a protocol, algorithm, or other inventory of actions. Our Clinical Pathways are developed by multidisciplinary clinical care teams to provide guidance on the evaluation and management of given chief complaints, diagnoses, or clinical processes that can be applied across the care continuum. Pathways are intended to cover 80% of the intended population, not every single patient.
Adherence to the clinical pathway recommendations should limit unwanted or unintended variation in practice, but pathways are not meant to be prescriptive. The clinician retains the responsibility to select the appropriate pathway for a particular patient and to use the pathway to the extent that it serves the individual patient. Variation resulting from specific patient characteristics is preserved; variation from the provider is eliminated.
Clinical pathways can be utilized as a foundation for quality improvement efforts. They may serve as underlying process maps that when paired with metrics can be used to monitor the effectiveness and efficiency of patient care. They are living documents that can be adapted continuously to improve care by incorporating new evidence as well as results from measurement. They have a powerful role in closing the gap between existing evidence and real-time clinical decision making.
As we strive to become a Continuously Learning Healthcare System, the Clinical Pathways Program will enable Children’s Hospital of Philadelphia (CHOP) to:
- Engage multidisciplinary teams in embedding evidence & local expertise into the delivery of pediatric medical care
- Reduce unnecessary variation in care
- Reliably measure the quality of care we provide
- Iteratively incorporate new evidence and information from measurement and clinician/family feedback into care recommendations