Although the philosophy of PATH can be applied by individual clinicians, PATH works best when practiced by the entire team. That said, each team member will need to be familiar with the model and apply skills appropriate to their level of training.
PATH training involves several levels of skill and competency, from being ‘PATH Aware’ to full certification as a PATH clinician. Our implementation services can help you with change management and evaluation of your new program. Get in touch and let us help you figure out which options are right for you and your team.
Here are possible implementation strategies:
Level 1: Identifying Frailty
Objective
Identify and respond to frailty prior to an intervention or high-risk treatment in:
- Preoperative clinics
- Procedural clinics (e.g., Transcatheter Aortic Valve Implantation (TAVI))
- Pre-dialysis clinics
- Medical oncology services
Training competencies
Each team member learns:
- How frailty impacts clinical decision-making
- How to quickly and accurately measure and stage frailty
- How to screen for cognitive impairment and refer for further assessment, where available
Level 2: Team-Based Care
Objective
Comprehensively assess the drivers of frailty (mobility, cognition, function, and social circumstances) in a way that decreases repetitive assessments and builds team efficiency
Training Competencies
Each team member is able to:
- Understand why a new approach to frailty is needed
- Comprehensively assess the drivers of frailty: mobility, cognition, function, and social circumstances
- Describe the diagnosis of dementia and dementia stages
- Communicate the impact of frailty to patients and/or their family
Level 3: PATH Consultation Service
Objective
Develop frailty-specific care plans, such as:
- Whether to undergo surgery or other interventions, such as transcatheter aortic valve implantation (TAVI), orthopaedic surgery, chemotherapy, or dialysis
- How to provide end-of-life care in frailty
- How to respond to a health criss
Training Competencies
Physicians and nurse practitioners are able to:
- Understand why a new approach to frailty is needed
- Comprehensively assess the drivers of frailty: mobility, cognition, function, and social circumstances
- Describe the diagnosis of dementia and dementia stages
- Communicate the impact of frailty to patients and/or their family
- Identify and prioritize treatment goals that are truly impactful to the patient and family
- Communicate the patient story to the patient and/or caregiver
- Respond to a health crisis
Level 4: Sector-wide PATH Implementation
Objective
Improve the transfer of information and navigation across the healthcare continuum with access to PATH consultation for challenging cases
Training Competencies
- Efficiently evaluate and understand frailty
- Exchange information with each other, across services, and with patients/families
- Refer complex patients for a more comprehensive assessment
The above training programs are delivered through your hospital or facility using:
- Web-based modules
- On-site training
- PATH mentorship
- Instructional videos and written materials
- Collaborative Comprehensive Geriatric Assessment (CoCGA): a shared assessment for the entire team
- PATH assessment tools
- PATH Manual
- PATH Frailty Assessment App for iPhone and iPad
- Materials for patients/caregivers