Meeting the Patient's Needs

Agencies need to stress the importance of MEETING THE PATIENT'S NEEDS, NOT THE PATHWAY'S NEEDS. Clinicians must feel comfortable putting a variance code when an intervention is not done or when an outcome is not met. Many clinical managers who have reviewed pathways documentation have been concerned that clinicians are checking interventions as complete and outcomes as met when they really aren't. This must be discussed at team meetings. Present different situations when all of the interventions may not be done because of different variance codes. For example, on CHF visit 3, the main focus of the visit was on a secondary condition, IDDM. Most of the teaching was directed toward the IDDM and the completion of the CHF teaching interventions was not feasible and was not done. Therefore, a variance code, 2, should be placed on the lines to the right of interventions not done because of a secondary condition. Further, the outcomes associated with the CHF teaching may also not be met and should be documented as not met with a variance code, 2.