Computerized pathways make job easier

Once a home care agency has created its own critical pathways, the next logical step is to put them on a computer.

At least that’s what the quality and case manager of the Visiting Nurse Corp. of Colorado in Denver hopes to do as soon as the budget allows.

"One thing we’ve worked closely on is restructuring the critical pathways so they’ll fit in our computerized documentation system," says Sandra Fragleasso, RN, MS, director of clinical programs and quality improvement.

When the pathways are computerized, two problems will be resolved:

• The critical pathways written on paper can be cumbersome because there are different goals suggested for each visit, and only two visits can fit on one sheet of paper. The computer pathways would not have this difficulty.

• If a patient has multiple diseases, such as congestive heart failure and diabetes, then the nurse might use two different critical pathways that have some duplication. However, because this would double the paperwork, the agency currently has nurses select the main diagnosis and follow the pathway for only that disease.

Fragleasso says the computer documentation program would combine the two or more different critical pathways and eliminate duplication. Then the nurse could easily document care for all of the patient’s diagnoses.

The drawback to computerized critical pathways? Fragleasso says the system is expensive, due to computer upgrades.