Clinical pathways from conception to outcome

A provider must demonstrate superior performance in several areas, such as cost, utilization, and clinical outcomes, to obtain designation as a Center of Excellence. A comprehensive orthopedic strategy was designed for use by Good Samaritan Health Systems to obtain this designation. The strategy included the development of clinical pathways and a profiling system. Acute, subacute, home care, and patient/family pathways were developed for diagnosis-related group 209: total joint replacement. Six months after implementation, a profile was developed using the Dartmouth Clinical Value Compass. Dimensions profiled included patient satisfaction, clinical variance data, functional status, and cost/utilization data. Improvements were identified in patient satisfaction, cost/utilization, and patient care.