• The healthcare system is complex with numerous governing bodies involved. Clinical Pathways allow for a cohesive, integrated portal for all levels of practitioners to access.
• The Clinical Pathway brings together community, primary and secondary care into a single pathway for the patient.

• Clinical Pathways have been widely adopted throughout New South Wales and Australia
• There are 9 Clinical Pathway Networks in NSW
• All Networks collaborate and share content, however all information is kept locally relevant with local clinicians and referral processes specific to that area

• General Practitioners have found the pathways particularly useful for less common presentation
• Junior Doctors have also found these pathways useful both in GP and Hospital systems as they provide specific information on management as well as practical information on how and when to refer a patient on
• Both Junior and Senior General Practitioners have found the pathways as a useful quality assurance tool, ensuring that all steps in the assessment, management and referral process have been considered
• General Practitioners have one of the most valued aspects of the pathways is the practical guide to referring patients. The pathways provide not only contact details for specialists within their area, they provide details to community services, Clinical Nurse Practitioners and non-government sectors

Example of the Use of the Clinical Pathways in the Primary and Secondary Care Centres

• Case in General Practice – A case of syphilis diagnosed in the community The patient presented to a local GP for routine STI testing and was found to have a positive result for Syphilis. The registrar was able to access the Clinical Pathway for Syphilis at the point of care and obtain up to date information on further assessment and management as well as the contact details to the local public health clinic. The registrar was then able to make the appropriate referrals and the patient was seen by a specialist the following week. What the registrar found most beneficial in this case was the ease of which they were able to access the information with details on points of contact for this specific presentation, saving both the patient and practitioner valuable time
• Case in a Local Hospital – A Heart Failure patient with multiple re-presentations This patient has had multiple presentations to the hospital with exacerbation of CCF. The patient’s representation were multifactorial including, poor compliance, poor health literacy and mental health factors contributing to her multiple presentations. The patient’s general practitioner, using the Clinical Pathways was able to obtain information regarding local services and programs for heart failure patients and was able to link this patient into a heart failure rehabilitation program in her local area. Subsequently this patient was not admitted to the hospital for an extended period of time
• Other commonly used pathways include antenatal, chronic hepatitis, abnormal liver function tests, palliative care

• Initially the pathways are developed by identifying areas of need. This information is gathered from feedback by GPs and specialists as well as the primary health network or the services themselves
• Once the need for a Clinical Pathway is established, a group of professionals from medical, nursing, allied health and general practitioners from the local area are brought together to collaborate on specifics in assessment and management and importantly establishing when and how to refer on to other services and where weaknesses lie in these processes
• During this process, weaknesses within the system can be scrutinised and this information is then passed on to relevant governing bodies

• Access for health professionals in Sydney’s Inner West is via the website:healthpathways.org.au
• Access to the website is free
• If you are a health professional in Sydney’s Inner West and would like to have access to the HealthPathways Sydney website please contact the HealthPathways Sydney Team who will provide you with a username and password. The Team can be contacted via email or telephone (02) 93952312 (Monday to Friday)

• The Clinical Pathways allow for easy access to comprehensive information based on clinical presentations which are relevant to the practitioner’s local area
• The information provided is developed by local practitioners allowing for a degree of confidence by the treating team to trust in the content of the pathway
• As the Clinical Pathways are in a centralised portal, practitioners can readily access information at the point of care

• Sydney HealthPathways