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CMs fight for acceptance of premature infant path
Responding to benchmarking data indicating that their length of stay for premature infants was above the national average, case managers at University Hospital-University of Colorado Health Sciences Center in Denver formed a multidisciplinary team to develop a pathway designed to address the problem. But they encountered stiff initial resistance from both staff nurses and physicians, many of whom regarded the pathway as "cookbook medicine." The main appeal to nurses was that the pathway's preprinted orders would help standardize care--a key selling point at this teaching hospital, where attending physicians and interns rotate in and out on a monthly basis. Case managers also changed the pathway's documentation requirements at the suggestion of the nurses, adopting a charting-by-exception approach. Physicians have been slower to come around, but the case managers are optimistic that outcomes data on the revised pathway, due within six months, will demonstrate the pathway's benefits.
Responding to benchmarking data indicating that their length of stay for premature infants was above the national average, case managers at University Hospital-University of Colorado Health Sciences Center in Denver formed a multidisciplinary team to develop a pathway designed to address the problem. But they encountered stiff initial resistance from both staff nurses and physicians, many of whom regarded the pathway as "cookbook medicine." The main appeal to nurses was that the pathway's preprinted orders would help standardize care--a key selling point at this teaching hospital, where attending physicians and interns rotate in and out on a monthly basis. Case managers also changed the pathway's documentation requirements at the suggestion of the nurses, adopting a charting-by-exception approach. Physicians have been slower to come around, but the case managers are optimistic that outcomes data on the revised pathway, due within six months, will demonstrate the pathway's benefits.