Developing new forms was a lengthy process

Project was a full-time job for some

When the Atlanta-based Shepherd Center, a specialty rehabilitation hospital, began the process of consolidating its assessment, documentation, and clinical pathway forms, the administration relieved essential team members of their other duties to work full-time on the project.

"This is my only job. To move from pathways to a comprehensive care path system in just a year is a full-time job," says Donna Court-Tillis, RN, MN, interdisciplinary pathway nurse, who spearheaded the effort.

Court-Tillis and Donna Loupus, RN, MN, CS, medical-surgical clinical nurse specialist, worked full-time on the project for a year. A third team member, Sarah Morrison, PT, day program supervisor, worked nearly full-time on the project.

Mary Nelson, a full-time secretary and desk-publishing expert, joined the team last September.

The staff at Shepherd has spent about 21¼2 years developing clinical pathways. It’s taken only a year to add the documentation component to the pathways.

The team started by gathering all the documents involving patient care.

"We looked at what was essential, what was redundant, and what was superfluous," Court-Tillis says.

Initially, a steering committee recommended what should be included in the documentation and the pathways. The committee included physician representatives, the director of nursing, the med-surg director, the director of education, and representatives from the therapy disciplines. A three-member core team, reporting to the hospital’s process improvement committee, refined the documentation.

The team sought input from everyone in the hospital and from external payer sources. For instance, it brought in external case managers for focus groups to make sure the documentation would provide the information the payers needed.

The team compiled the pathways into a bound guide for external case managers so they can refer to them when they get reports on patients.

All staff received inservice training on the new documentation and the new way of thinking about patient care. Support from the hospital staff at all levels was essential, Court-Tillis says.

"It’s not something you can do all by yourself," she explains. "Support has to come from the top down and from the bottom up."

[Editor’s note: For more information on Shepherd’s consolidated patient care forms, contact Donna Court-Tillis at (404) 350-7799.]