The Christiana Care Health System provides a model for successfully implementing clinical pathways across a wide range of diseases and stages.
Within the mid-Atlantic region of the US, the Christiana Care Health System (Wilmington, DE) has emerged as a leader in the development and implementation of clinical pathway programs. In 2016, Christiana Care introduced nine clinical pathway programs for subspecialties such as acute medicine, behavioral health, medical oncology, primary care, suicide prevention, and supportive care. Research for designing these programs occurred in collaboration with Christiana Care’s Value Institute.
Journal of Clinical Pathways interviewed Kenneth L Silverstein, MD, MBA, Christiana Care’s chief clinical officer, and a longtime proponent of value-based medical care, to discuss the process by which Christiana Care simultaneously integrated multiple clinical pathways, and offered advice for other hospital administrators considering clinical pathways.
When Christiana Care first began to implement clinical pathways, a goal was set for the fiscal year of 2016 to launch one pathway for all of their nine service lines. Dr Silverstein refers to these pathways as “capital P pathways,” which means that all providers who interact with patients on that pathway would know their role and the expectations within the care continuum.
In developing these pathways, leadership teams within each service line were tasked with developing the guidelines and were left relatively on their own to do so. When it came to implementing, the “PIT,” — pathway integration team — was utilized to centralize education and communication, data acquisition and analysis, information technology support, support from health care delivery science research, and project management support.
Dr Silverstein asserts that all nine of the pathway programs are experiencing success, but the ones in particular that are performing well are the surgical pathway, which involves complex ventral hernia repair, and the heart and vascular service, which focuses on non-ST-segment-elevation myocardial infarction.
In his concluding remarks, Dr Silverstein expresses his belief that including professionals across specialties is essential for designing clinical pathways. A multidisciplinary approach is key to a pathway’s success.
Click here to read the full interview. —Zachary Bessette
