Implementation of a Clinical Pathway System in Maternal Newborn Care: A Comprehensive Documentation System for Outcomes Management

Abstract

This article describes the design, implementation, and evaluation of an interdisciplinary clinical pathway system for maternal newborn care in a perinatal regional referral institution. Core issues in the design of this system are addressed to promote outcomes management and ongoing performance improvement. A discussion of the implementation follows, illustrating the lessons learned, changes made, and associated evaluation. This clinical pathway system has improved communication and collaboration among all disciplines, enhanced the discharge coordination process, and established protocols available to all members of the health care team.

Using a Clinical Pathway to Support Normal Birth: Impact on Practitioner Roles and Working Practices

“…This finding should not be surprising because the literature suggests that clinical pathways frequently start out with one aim and achieve another (9,11,47). These unintended outcomes may be positive, for example, enhanced communication between professionals (10,12), or negative, for example, increased interprofessional tensions (37).…”

“…The literature relating to clinical pathways in maternity care is limited, consisting mainly of opinion‐based articles (20,32) and descriptive accounts of pathway implementation (21,33–35) with few primary research studies (27,36,37). Maternity care pathways may focus on specific perinatal episodes such as postnatal care (33), or total care from admission to discharge (37). Pathways are more often used for high‐risk care.…”

“…Within intensive neonatal care (27,38–40), evidence of enhanced interprofessional communication is available, although Merritt et al caution that evidence of improved neonatal outcomes is minimal (27). A United States maternal and newborn clinical pathway improved interprofessional, collaborative processes for reviewing care, but did not alter length of stay or reduce costs (37).…”

Effect of Implementing Clinical Pathway to Improve Child-Birth and Neonatal Outcomes

“…The literature relating to clinical pathways in maternity care is limited, consisting mainly of opinion-based articles [5,14] and descriptive accounts of pathway implementation [16,17] with few primary research studies [18]. Maternity care pathways may focus on specific perinatal episodes such as postnatal care, or total care from admission to discharge [19].…”

The Effect of Care Pathways on Coronary Care Nurses: A Preliminary Study

“…[16][17][18][19][20] In addition, the leader or manager was mentioned as the key for implementing care pathways. [17][18][19][20][21] Identifying leaders or mentors could help encourage care pathway implementation after formal education. Moreover, Mcleod et al 22 stated that the implementation phase is conducted through regular conferences for nurses and doctors and webinars to teach health care providers.…”