A new Care Signature Pathway (CSP) launched in November of 2022 is helping physicians and staff across the Yale New Haven Health System (YNHHS) deliver consistent guidance on the pre- and post-procedure usage of anticoagulation medications. Nearly 15% of surgical and non-surgical patients receiving care at YNHHS require anticoagulants; the majority of whom see several prescribing physicians. Variation in recommendations as to when to start or stop a medication can be harmful, leading to confusion, safety events, canceled procedures, and longer lengths of stay.
“Some variation in clinical decision making is necessary to provide individualized care that meets each patient’s unique needs. But variation can be harmful if it leads to inefficiencies. A care signature pathway acts as a kind of GPS that provides clinicians with consistent recommendations for diagnosis, treatment, and care management, across a wide range of conditions and scenarios,”said Dr. Vanita Ahuja, Surgery Quality Liaison and physician leader on the anticoagulation pathway initiative.
The health system has developed more than 400 CSPs to date — a process that involves an extensive review of the medical literature, and the input of surgeons, physicians, and staff from multiple disciplines.
“Developing a pathway allows us, as a care team, to all be on the same page, so that the patient feels quarterbacked through a seamless process,” said Dr. Ahuja.
Kent Owusu, PharmD, a program manager with YNHHS Care Signature, led the development of the anticoagulant pathway, which includes guidelines for more than 700 surgical and non-surgical procedures, as well as best practices for communicating usage instructions to patients.
“We had more than 50 people contribute time and perspective to the development of this pathway, including members of the Patient Family Advisory Committee (PFAC), who helped us to identify communication gaps and improve guidelines for consistency and clarity,” said Owusu.
“We started this effort because it impacted patient care. It was appropriate that it circled back to patients to endorse the final product.”