Clinical pathways--a perioperative application

The application of clinical pathways as a means of streamlining health care and tracking outcome data for continuous quality improvement has been evolving continually since the late 1980s. In order for the clinical pathway process to be effective, it must be collaborative, multidisciplinary, and have administrative support and institutional congruency. Members of multidisciplinary work group at the University of California Los Angeles Medical Center have developed a perioperative clinical pathway for patients undergoing coronary artery bypass graft surgery. The process of developing a perioperative clinical pathway involved extensive preliminary preparation before actually designing the pathway and identifying outcome data. Ongoing reevaluation of pathway components is essential and future opportunities for expansion are apparent.