Designing and implementing clinical pathways for children with traumatic brain injuries

The growth of managed care, in particular, has made statements regarding the potential progress of children with traumatic brain injuries more and more necessary prior to admission. In addition, institutions and programs have been held responsible for documenting positive progress in a more systematic fashion than previously. Typically, clinical pathways are documented timetables describing progress and outcome in medical settings. This article will present rationale for the need to develop clinical pathways, what components and rehabilitation areas should be included, and how to implement such pathways. Specific aspects of pathways can be formulated to meet the needs and reflect the characteristics of children with traumatic brain injuries. Incorporating clinical pathways into school, community re-entry, and program evaluation will also be discussed. Pathways can be valuable tools in communicating with families, funders, and clinical staff, as well as tools for program evaluation.