Title : Standardization of cardiovascular care using clinical pathways – a practical approach to implementing clinical guidelines and evidence-based medicine
Abstract:
While cardiovascular disease remains the most common cause of death worldwide, clinical approaches to the management of common cardiovascular conditions such as heart failure, coronary artery disease, and atrial fibrillation vary widely from institution to institution and from provider to provider. Despite the existence of widely-published multi-society guidelines for many cardiovascular conditions, initial diagnostic workup, medical therapy, timing of referral for procedures, and other pivotal decisions in the care continuum are often guided more by provider habit and practice inertia rather than the most recent available evidence, leading to variation in clinical outcomes. Standardization of these and other care processes related to the workup and treatment of cardiovascular conditions leads to more reproducible outcomes and overall improvement in patients' symptoms and quality of life. However, distilling the large volume of available evidence and guidelines into practical care algorithms which providers can use to guide care in the real world can be a daunting task. Clinical pathways are a powerful tool for standardizing care processes and guiding providers toward the most evidence-based approaches to common conditions. In this lecture, we will discuss a practical approach to building clinical pathways for the management of common cardiovascular conditions in the inpatient and outpatient settings including our approach to weighing available evidence, building provider consensus, designing and refining the pathways, initial pathway launch, sustaining the change, measuring success, and updating the pathways as new evidence emerges. This discussion will draw heavily from our 10 years of experience building clinical pathways at the University of Chicago with special focus on generalizable points that can be applied to attendees’ home institutions.
Audience Take Away
By the end of this discussion, attendees will:
- Understand how practice variation affects clinical outcomes
- Understand common factors leading to practice variation
- Understand how clinical pathways can be used to standardize practice
- Understand the process by which clinical pathways can be constructed and refined
Understand common pitfalls and barriers to pathway usage and how to address them
