The Importance of Pathways: Trauma Center and Neurocritical Care Unit

Severe traumatic brain injury (TBI) is a major source of morbidity and mortality, especially in blunt trauma patients. Advances in medical care have increased the number of survivors of TBI, producing social consequences and challenges of an increasing pool of people with cerebral injury with approximately 80,000 survivors annually. As such, direct medical costs for TBI treatment are estimated at over $48-billion dollars per year. Clinical pathways are “road maps” that provide a detailed framework for all aspects of patient care during hospitalization. Pathways have been demonstrated to improve outcomes with respect to reducing ventilator days, ICU length of stay, morbidity, and improved short- and longer-term neurologic outcomes. While labor intensive, TBI pathways may help curtail substantial costs associated with TBI care and lead to improved quality of care.