title: Quality toolbox: clinical pathways can improve core measure scores.
abstract: Clinical pathways (CPs) are decision-making tools designed to improve the quality of patient care processes and reduce costs. We conducted a retrospective analysis to determine whether multidisciplinary CPs had improved core measure scores. Comparative data to document secular trends were obtained from 45 Maryland hospitals. There were 6013 discharges with community-acquired pneumonia (CAP), congestive heart failure (CHF), or acute myocardial infarction (AMI) for the 3-year data collection period ending in 9/30/05. The 72.5% of cases in which CPs were employed to manage CAP, CHF, or AMI were significantly more likely to meet the Appropriate Care Measure (ACM) standards than the 26% that did not (81% vs. 67.8%, p < .001). Scores for all 10 ACM components for CP-managed patients were better than Maryland state averages. Improvements were stable over a 3-year period of time.
authors.affiliation: University of California, San Francisco, CA, USA. jack.mccue@post.harvard.edu
authors.forename: Jack D
authors.initials: JD
authors.lastname: McCue
authors.forename: Adam
authors.initials: A
authors.lastname: Beck
authors.forename: Kevin
authors.initials: K
authors.lastname: Smothers