All, regardless of format, serve as potentially powerful communication instruments, frequently stimulating questions and dialogue between patients and the care team. Communication among health care personnel has been shown to have more effect on which patients live and which patients die than technology or other lifesaving treatments. Certainly, lack of communication is a common critical omission by nurses and may lead to a breach of duty. 11 Clinical paths also can function as interdisciplinary progress notes. These particular instruments actually combine the path with the documentation form in the medical record.
All providers document their notes on the same tool, thus increasing effective communication.
Communication is further augmented when the interdisciplinary team develops an effective system to communicate variances from the clinical path among themselves. A variation is defined as any deviation from the pathway's schedule of clinical assessments, interventions, or outcomes. In certain hospitals, the clinical path and variance reports are not part of the chart because of feared legal repercussions. In other institutions, both the path and variance report are an integral part of the medical record. Whatever the protocol, an effective method for communicating variances among team colleagues is critical.