Home care's role in clinical pathways

Abstract

In 1989, the leadership of Anne Arundel Medical Center made a commitment to refocus its energies on measuring and improving performance. The continuous performance improvement plan in cluded several key initiatives, one of which was the development of clinical pathways. Clinical pathways have existed in health care organizations for several years; unfortunately most efforts have focused on inpatient management with emphasis on physician and nurse activities. The clini cal pathways in Anne Arundel Medical Center begin with the patient at the point of entry into the health care system and end at the point of optimal wellness. The Home Health Agency is currently integrated into 13 clinical pathways. The clinical pathway for total hip replacement is discussed to demonstrate home care's unique role. Outcomes for the initial 2 years of the pathway demonstrate positive clinical outcomes, positive perception of services, and cost-effective use of resources.