CLINICAL PATHWAYS FOR THE HIGH-RISK PATIENT

The goal of managed health care is to reduce health care costs while m aintaining or improving the quality of care given to patients, Clinica l pathways, which outline the services and therapies planned for a typ ical patient admitted with a specific diagnosis, may provide a way to control costs and improve patient outcome. These pathways are under de velopment by medical centers and managed-care organizations nationwide , with the aim of planning, managing, documenting, and evaluating mult idisciplinary care. A coordinated care plan can take a number of appro aches. Time lines identify predictable clinical landmarks and time int ervals for a specific medical episode or illness within a given diagno stic-related group or set of diagnostic-related groups. Case-managemen t plans and case managers coordinate a patient's care throughout an ep isode, eg, an operation, enabling patients to reach defined time point s in the course of their care at the expected time, Critical pathways are the favored method of documenting the patient's progress according to the predicted time schedule. This report discusses ways to success fully implement a care plan, highlighting the commitment and effort ne eded from a multidisciplinary staff to achieve the goal of optimizing efficiency and quality of patient care. Copyright (C) 1997 by W.B. Sau nders Company.