Objectives

• To provide a clinical pathway management system which can be adapted for various levels of automation.
  
• To provide a comprehensive care path revisioning system in line with medical legal requirements.
  
• To facilitate the design and development of multidisciplinary clinical pathways specific to organisational requirements
  
• To maintain established banks of;
  a) Approved clinical pathways
  b) Approved actions / outcomes for pathway development and variance reporting
  c) Approved patient outcome goals related to specific pathway indicators for     pathway development
  d) Approved causes for variance reporting
  e) Approved problems / risks associated with specific pathway indicators for     pathway development.
  f) Approved patient activities for developing patient pathway handouts.
  
• To provide a quick reference to descriptions of pathway actions with links to the organisation’s automated policy and procedure manuals
• To provide hard copy PREDICTED and/or ACTUAL clinical pathways
  
• To provide a patient pathway handout
  
• To provide a user friendly and efficient system for monitoring and recording variances to multidisciplinary clinical pathways
  
• To enable dynamic variance reporting utilising preset criteria defined within the program
  
• To produce graphical data which highlights patients on clinical pathways who have extended lengths of stay
  
• To produce graphical data to highlight the type and occurrence rate of causes which decrease compliance to pathway standards and patient outcomes
• To provide a daily audit of all outcomes not marked in TrendCare. This ensures a high level of compliance to variance reporting.

Clinical Application

Design and Development

The TrendCare clinical pathway system includes a feature which enables the user to generate clinical pathway design forms. These forms facilitate a multidisciplinary approach to clinical pathway development and can include pre admission and post discharge care, various care areas (e.g. recovery, operating theatre, emergency, etc), PHASES – groups of days (e.g. used in psychiatry and rehabilitation) and DAYS. Preset standards for length of stay are able to be applied to encourage best practice. Extension days can be developed so that variance reporting can be retained for patients with extended lengths of stay.

Maintenance

Approved clinical pathways are loaded into the TrendCare maintenance database. This process simultaneously develops a bank of actions relevant to care indicators making the loading of future pathways much quicker.

A bank of potential causes of clinical pathway variances can be loaded into the maintenance database to provide fast and accurate variance reporting. The TrendCare security system ensures limited access to the clinical pathway maintenance system so that care standards can not be adjusted by unauthorised users.
Clinical Management

Clinical pathways can be allocated to a patient at a pre admission clinic, on admission or during the patient’s episode of care. Clinical pathways can move across the continuum and include any care area along the continuum e.g. recovery, theatre, etc. A patient can “mark time” on the pathway and may move from one pathway to another.
During each shift carers identify which actions / objectives have been achieved or not achieved and mark them accordingly. The cause of variances to pathways are identified and logged by selecting from the preset bank or creating a new cause. Similarly clinical actions are selected and added to the pathway.

By using the concept of “banks” there is minimal data entry required from the user and variance reporting is more accurate. The TrendCare security system ensures that each user’s entry is identified through their unique logon and password.

A more detailed description of the action can be viewed and comments relevant to actions taken, not taken or deferred can be entered by the user and retrieved for future reference. The option to link to automated policy and procedure manuals has been developed to assist new learners.

Reports Generated

• Complete Clinical Pathway identifying variances to actions / outcomes and all staff providing care.
• Patient Episode of Care Variance Report
• Patient Episode of Care Outcomes Report
• Variance Report for a Specific Cause (over a selected time period)
• Variance Report for a Specific Indicator (over a selected time period)
• Extended Length of Stay for a Specific Care Path (over a selected time period)
• Extended Length of Stay for a Specific DRG (over a selected time period)

Graphs Generated (in excess of 20 graphs generated)

• Click to enlarge

  Variance to Length of Stay
• Types of Causes related to Clinical Pathway Variances
• Occurrence Rates for Specific Causes of Clinical Pathway Variances
• Variances to Outcomes for Specific Clinical Pathways

N.B. All TrendCare reports and graphs can be saved as PDF files and can be emailed.