Effective strategies to increase the visibility of pain and the accountability of health-care professionals for the treatment of pain are needed to improve the quality of pain management. Critical pathways are tools used to plan and document care for patients within a system of case management. Case management models of care focus on decreased cost, better coordination of services, and improved patient outcomes. This article describes how critical pathways are being used in one setting within a system of case management to help increase awareness of pain as a problem and to institutionalize pain management. As institutions seek to implement outcome-based practice systems, many are turning to the critical pathway to influence practice patterns. Critical pathways provide the vehicle to articulate and implement a standard for quality pain management and a mechanism to analyze persistent failures in achieving desired outcomes of care. Using pathways to track and monitor care promises to uncover clinical barriers to pain management and provide an impetus to increase clinician accountability for pain relief.
