Barb Kilpatrick's road to recovery following surgery at OTMH was eased by the use of tools known as Care Paths and Patient Pathways.

During her visit to the PreAdmission Clinic at OTMH about a week prior to her surgery, Mrs. Kilpatrick was given a patient pathway for total knee replacement surgery. The nurse reviewed the procedure, what to expect and the recovery process. She also met with a Pharmacist to discuss her concerns about pain management and medication, her physiotherapist and occupational therapist to discuss rehab exercises, and a Community Care Access Centre (CCAC) Case Manager to talk about her home care needs after discharge. "I felt like I was involved in my recovery from the word go. I was an active participant and partner in my own care," explained Mrs. Kilpatrick. "I felt more comfortable going into the surgery knowing that my care had been mapped out so meticulously."

A team Care Path and the Patient's version of the Pathway can be likened to road maps which can cover the whole journey of care from preparing the patient for the treatment or procedure to recovery in the hospital, through to a seamless transition to homelife. This plan of care clearly outlines the sequence and timing of the treatments and health services for the management of care for a specific health condition.

Lynn Budgell and Kris Rogers, both nurses and Professional Practice Clinicians for Care Paths and Utilization at Halton Healthcare Services (HHS) coordinate the development of Care Paths as part of their roles at HHS. "Care Paths are just one of the clinical management tools we use. They help us deliver the highest quality of care in our hospitals within the given resources we have. Care Paths are often developed for predictable conditions or high volume patient groups such as the uncomplicated heart attack, total hip replacement, or a vaginal birth," explains Lynn.

"They map out the entire treatment process by describing what should happen, when, and in what order. It is a very detailed plan of what diagnostic tests are required, what patient progress caregivers should look for each day, and what type of caregiver needs to see the patient," adds Kris. "It discusses the patient's medication, nutrition, prescribed activity at each stage of recovery, and a list of criteria for safe discharge planning."

While the staff use the clinical Care Paths, a patient version of the patient pathway is usually developed for patients and their families. These "care path tools " enhance communication between the health care team, the patient and the family and are an ideal educational supplement. When feasible, the Care Path Team tries to provide the patient with other learning materials like booklets and handouts.

"The Patient Pathway spells out the course of treatment and recovery step by step for the patient in easy to understand language," explains Lynn. "It becomes a teaching tool for the all the caregivers who work with the patient, by including information on home care, related outpatient programs, and who to call if they need help."

"There's nothing worse than the unknown. The patient pathway for my knee surgery was very accurate," explained Mrs. Kilpatrick. "While nothing can prepare you for pain, the pathway gave me a pretty good idea of what to expect each and every day of my recuperation- and it's been right on the money so far!"

Care Paths are developed by a team of healthcare professionals including family physicians and specialists, nurses, physiotherapists, speech pathologists, pharmacists, occupational therapists, social workers, homecare workers and any other type of health professional who might be involved with that group of patients. The combined knowledge and experience of all these caregivers are integrated into the care path to provide a very well thought out comprehensive care package.

"Care Paths follow the best possible health care practices known and available to us," explains Kris. "They ensure consistent quality care by mobilizing the care team members into action. With a Care Path in place, every caregiver is clear on their roles so there is no duplication or wasted time. This approach to care delivery translates into more immediate quality care for our patients while maintaining flexibility for each patient's individual needs."

"The health professionals I met at the Preadmission Clinic cared and worked with me daily following my surgery. They encouraged and supported me every step of the way. I got a very comprehensive total care package which followed me home with the home care they arranged," explained Mrs. Kilpatrick. "The Care Path Team put a lot of thought into the plan. Everything was planned out to the last minute detail. I got a well coordinated total care package."