Clinical Pathways

Middlesex Hospital has established special treatment plans called “clinical pathways” – developed by physicians and hospital staff – to make sure that all patients who are treated with a particular disease receive a course of treatment which has been proven to be effective. Today, the percentage of usage of clinical pathways by physicians here is an impressive 85%.

Middlesex Hospital currently has clinical pathways in place for 22 different conditions, including alcohol withdrawal, asthma, chest pain, congestive heart failure, breast surgery, gastric bypass, acid reflux disease, hysterectomy, minimally invasive gall bladder removal, pneumonia, stroke, total joint replacements (hips and knees) vaginal and Cesarean births, diabetes and pancreatitis, among others. Clinical pathways may not be appropriate for all patients because of certain unique situations related to their condition. The decision to use a pathway is made by the physician.

For example, a unique breast surgery pathway is being used by the Hospital’s general surgeons in their private practice offices, for any patient with a lump or positive mammogram. It offers these patients extra support and services (such as the Hospital’s Breast Care Coordinator or a referral to social work or behavioral health) prior to a breast biopsy; and a referral to a radiation oncologist and plastic surgeon prior to surgery. Until the adoption of this program, most patients received no additional support until the results of their breast biopsy were known.