The ‘1 thing’ that will consistently improve throughput, per Catholic Health’s quality chief

More hospitals and health systems should be focusing on developing evidence-based clinical pathways as part of broader efforts to free up capacity and improve operational efficiency, according to Chhavi Katyal, MD, senior vice president and chief quality officer at Catholic Health in Rockville Centre, N.Y.

“One thing that gets overlooked is creating good clinical pathways where us clinicians can come together and make sure that, for common conditions, we have order sets and pathways,” Dr. Katyal said in a recent interview with Becker’s. 

“What clinical pathways do is provide a structure for our clinicians in their day-to-day work to decrease variability in the care patients get and really an evidence-based practice to ensure patients get good care every single time,” she said. 

Across the country, hospital and health system leaders are focused on improving patient access through efforts to boost operational efficiency. This work is increasingly critical, as demands for care increase and emergency department boarding worsens. When built around evidence and frontline input, clinical pathways help reduce unwarranted variation — a well-documented driver of inconsistent outcomes, avoidable costs and operational inefficiencies. Health systems that focus on reducing variation have seen measurable gains in care quality and cost savings.

Having reliable clinical pathways in place is “the one thing that will decrease length of stay consistently and persistently over time,” Dr. Katyal said. She’s experienced this firsthand.

Prior to joining Catholic Health, Dr. Katyal was the medical director of The Children’s Hospital at Montefirore in New York City’s Bronx borough, where a significant portion of annual admissions were related to asthma. Aiming to reduce variability, the hospital’s pulmonologists convened to create an evidence-based clinical pathway for managing asthma — an effort that reduced length of stay by one day, Dr. Katyal said. 

Now, at Catholic Health, which operates six hospitals, clinical teams are working to develop pathways for common diagnoses, such as heart failure. 

“I can almost guarantee it will decrease our length of stay across the system,” Dr. Katyal said. 

She emphasized that clinician engagement is essential to this process, with frontline teams leading the development of pathways and reaching consensus on evidence-based best practices that reflect real-world workflows.

“When it’s done with subject matter expertise, it’s very helpful for managing capacity, very helpful for decreasing length of stay. I’m not saying we don’t have to do everything else – escalation huddles, make sure our tests are done on time. All of those things have to happen, but if we take time to do clinical pathways, it changes the game.”

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