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Related Experiment Videos

An interdisciplinary, evidence-based process of clinical pathway implementation increases pathway usage.

Leigh Kinsman1, Erica James, Jennifer Ham

  • 1Department of Nursing, School of Health and Environment, Bendigo Campus of LaTrobe University, Victoria, Australia. l.kinsman@latrobe.edu.au

Lippincott'S Case Management : Managing the Process of Patient Care
|July 27, 2004
PubMed
Summary

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Implementing clinical pathways, like the one for acute myocardial infarction (AMI), through genuine collaboration significantly boosts healthcare professional usage. This evidence-based approach enhances patient care by increasing documented pathway adherence.

Area of Science:

  • Healthcare Management
  • Clinical Practice Improvement
  • Evidence-Based Medicine

Background:

  • Clinical pathways aim to bridge the gap between medical evidence and healthcare practice.
  • While generally improving outcomes, their effective utilization by health professionals is often hindered by weak implementation strategies.
  • Low documented usage of clinical pathways can limit their potential benefits.

Purpose of the Study:

  • To assess if an interdisciplinary, collaborative, and evidence-based implementation process increases the documented use of an acute myocardial infarction (AMI) clinical pathway.
  • To evaluate the impact of genuine team involvement on the ownership, acceptance, and subsequent usage of clinical pathways.
  • To measure the change in AMI clinical pathway presence in medical records and completion rates post-implementation.

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Main Methods:

  • A before-and-after study design was employed in a regional Australian hospital.
  • Documented clinical pathway usage was quantified by auditing the presence and completion rates of the AMI pathway in patient medical records.
  • A total of 195 medical records (124 pre-implementation, 71 post-implementation) for patients diagnosed with AMI were analyzed.

Main Results:

  • The interdisciplinary implementation process led to a statistically significant increase in documented AMI clinical pathway usage.
  • Documented usage rose from 22.6% before implementation to 57.7% after implementation (p <.000).
  • The findings demonstrate a strong correlation between collaborative design and increased staff utilization.

Conclusions:

  • Involving healthcare professionals in the design and implementation of clinical pathways is crucial for enhancing their utilization.
  • A genuinely collaborative and evidence-based approach can overcome barriers to clinical pathway adoption.
  • This study highlights the effectiveness of team-centered strategies in improving the practical application of clinical guidelines.