Get all your medical specialists and ancillary support services on board. Physician leadership and participation are key to the success of the streamlining effort. Put any recalcitrant colleagues on the committee so that they can understand all the issues and advocate for change. And the savings have been huge - hundreds of thousands of dollars per year. Other services at the hospitals are developing their own clinical paths.
Teams learn from each other and in some cases, implement other service's successes.
Revised sedation regimens, for example, developed for open heart surgery patients, have been implemented in all ICUs. Craver says no. This is highly ordered and prescribed medicine taking advantage of individual patients' resources and their abilities to respond to a fast-track program. Our pathway is a guideline, not an end in itself, and won't be successful for all patients. While admittedly not all patients are as enthusiastic about shorter stays and more personal responsibility for their recovery or are too ill to take advantage of new practices, the best testimony to clinical pathways' successes comes from patients like Richard Johnson.