Effective strategies to increase the visibility of pain and the accoun
tability of health-care professionals for the treatment of pain are ne
eded to improve the quality of pain management. Critical pathways are
tools used to plan and document care for patients within a system of c
ase management. Case management models of care focus on decreased cost
, better coordination of services, and improved patient outcomes. This
article describes how critical pathways are being used in one setting
within a system of case management to help increase awareness of pain
as a problem and to institutionalize pain management. As institutions
seek to implement outcome-based practice systems, many are turning to
the critical pathway to influence practice patterns. Critical pathway
s provide the vehicle to articulate and implement a standard for quali
ty pain management and a mechanism to analyze persistent failures in a
chieving desired outcomes of care. Using pathways to track and monitor
care promises to uncover clinical barriers to pain management and pro
vide an impetus to increase clinician accountability for pain relief.