Clinical Pathway Implementation at David Grant Medical Center: Evaluation and Recommendations.

Abstract

Abstract : The managed care environment present in the American Health Care System and the Air Force Medical Service demands the need to manage the triad of health care: quality care, access to care, and the cost of health care. The area of utilization management, more specifically the development of clinical pathways, plays an instrumental role in the management of this 'Triad.' It was the purpose of this study to determine the effect of clinical pathway implementation on the length of stay for patients in specific DRGs. Additionally, it was the purpose of this study to help develop a mechanism to: (1) identify diagnosis for clinical pathway development; (2) properly develop Clinical pathways; (3) properly implement clinical pathways; and (4) successfully evaluate the impact that a clinical pathway has when implemented. The study found that for the four diagnoses examined length of stay decreased, but the decrease was not statistically significant. Recommendations are made to assist in the identification, development, implementation and evaluation of clinical pathways. Pressure in today's budgetary environment demands that DoD medicine become more cost effective to survive. Clinical pathways can assist in the production-of-high quality, cost effective care, simultaneously increasing access.