Mc-Chpt 29 Clinical Pathways (Critical Paths) (Pert Networks)

Front 1

Environment that is right for Implementation of Clinical Pathways

Back 1

 Strong reason to change
 Champions
 willingness to challenge current practices
 desire to standardize
 MCO covers same scope of services

Front 2

Advantages of Using a Clinical Pathway

Back 2

 goal setting
 agreement on resources
 Reduces practice variation
 Clarify big picture
 Coordination & Communication
 Educating staff
 use as a Benchmark
 Clarifies patient's responsibilities
 Legal safety

Front 3

Structure of Clinical Pathway Models

Back 3

 Coordinate multiple activities
 Optimistic, Pessimistic, Realistic times
 Precedent relationships
 Slack times
 The Critical Path is the sequence of necessary activities that takes the most time.
 This is the minimum time it can take to run the path.

Front 4

How to Develop a Clinical Pathway

Back 4

1. Select the diagnosis, procedure, or condition
2. Define the scope
3. Select a multidisciplinary team of experts
4. Flowchart the process
 compare with current practices
5. Identify the desired outcome
6. Be aware of new technology
 Question current practice
7. Define intermediate objectives
8. Determine necessary activities
9. Determine precedent relationships
10. Determine Activity Durations
11. Find the Critical Path
12. Implementation

Front 5

How To Use a Clinical Pathway

Back 5

 at different "scopes"
 different paths depending on patient’s health

Steps:
1. Notify Pathway coordinator on admission
2. Patient is "initiated" on pathway
 dates entered on nodes
3. clarify questions in advance
4. Variance Documentation (A/E) for each step
 Why?
 Which patient, system, and doctor?
 Quantitative, not qualitative
 Which future activities will be affected? Slack time?
5. communication and monitoring (prospective)

Front 6

FORMATS OF CLINICAL PATHS ON PAPER

Back 6

 Activity/Precedent format
 Gantt Chart format
 Flowchart/Network format
 Resource format

Front 7

Mnemonic:

Method
(alphabetical)
Easy When Res. Prec. Slack Crit P.
Activity/Precedent format n Y Y n
Flowchart/Network format Y n Y n Y
Gantt chart format Y Y n n n
Resource format Y n Y n n n

Y = yes (advantage)
n = no (disadvantage)

Column Headers:
Easy = Easy to use/discuss changes
When = tells you When to do each activity
Res = tells you what Resources you need

Prec = shows Precedents
Slack = shows Slack times and Durations
Crit P = shows the Critical path

Memorizing Hint: notice that
both shaded regions look identical.



Done.

Back 7

Blank