Pathways bring dramatic clinical results.

Abstract

Although physicians at Good Samaritan Health System in Kearney, NE, first offered stiff resistance to case managers' efforts to implement a clinical pathway program, efforts to educate the physicians about the benefits of pathways have led to a turn-around in which physicians now are asking the director of case management to create even more pathways. One key step in promoting the pathways was to create a reporting profile capable of evaluating clinical pathways. In addition, the hospital produced a video for each pathway that describes the patient's care from preadmission through discharge. Most significantly, case managers at Good Samaritan avoided creating an adversarial relationship with physicians in the system. They dodged charges of pathways being "cookbook medicine" by establishing a system in which pathways are not automatically applied; physicians have to write an order for a patient to be placed on a pathway.