Analyses from Intermountain Health Care, Salt Lake City, Utah, suggests that teams of physicians, nurses and other staff have little knowledge of the practice of others. 15 Clinical pathways address both of those issues. The process of developing a clinical pathway facilitates multidisciplinary communication, data collection, data analysis and feedback to providers. Grassroots development of the pathway taking into account the published literature and the practice patterns of physicians and other members of the health care provider team. Implementation of a clinical pathway from the top down is doomed.
Unambiguous language is essential.
Whatever practice one is trying to change requires constant reminders, keeping as close to the planned medical service as possible. Measuring the effect of the pathway on outcomes, cost and patient satisfaction is essential to evaluate the impact of the pathway. Incentives are important and do not have to be a monetary reward. Recognition and demonstrated appreciation for a job well done can serve as a good incentive. Pathways must allow clinical flexibility.