1. Date of download: 6/1/2016 From: Critical Pathways as a Strategy for Improving Care: Problems and Potential Ann Intern Med. 1995;123(12):941-948. doi:10.7326/0003-4819-123-12-199512150-00008 The first 2 days of a simplified critical pathway for patients who have had cardiac surgery.This general time-task matrix format, also known as a Gantt chart, indicates for each day of care the corresponding multidisciplinary staff actions and expected patient outcomes. CT equals chest tube; CXR equals chest radiograph; EKG equals electrocardiogram; ET equals endotracheal tube; ICU equals intensive care unit; MD equals physician; PO equals by mouth; POD1 equals first postoperative day;. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

2. Date of download: 6/1/2016 From: Critical Pathways as a Strategy for Improving Care: Problems and Potential Ann Intern Med. 1995;123(12):941-948. doi:10.7326/0003-4819-123-12-199512150-00008 Documentation of expected actions and outcomes.A simplified version of a page from a critical pathway for patients who have had coronary artery bypass surgery. This page shows some of the actions and intermediate outcomes that are expected to occur on the day of surgery. A level of detail suitable for nursing documentation is included, but, to encourage physicians to participate, only the two elements that are the most important to them are indicated in bold print: 1) ordering an anesthesia consult as part of an early extubation protocol and 2) adequate pain control with analgesics. D equals day nursing shift; E equals evening nursing shift; N equals night nursing shift; VAR equals variance. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

3. Date of download: 6/1/2016 From: Critical Pathways as a Strategy for Improving Care: Problems and Potential Ann Intern Med. 1995;123(12):941-948. doi:10.7326/0003-4819-123-12-199512150-00008 Variance documentation.This figure shows a simplified version of the page of a critical pathway for patients who had had coronary artery bypass surgery that is used if a patient does not achieve the “gateway” of expected transfer from the intensive care unit to an intermediate care bed within 24 hours after surgery. Reasons for the variance are documented by the nurse who is caring for the patient at the beginning of the patient's second day in the intensive care unit, and these data are used in ongoing evaluations of the pathway and the care process. D equals day nursing shift; E equals evening nursing shift; ECG equals electrocardiogram; N equals night nursing shift; VAR equals variance. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians