Pathways4Kids Intake Form

Please list your hospital name, city, and state.

(e.g. All Children's Hospital, St. Petersburg, Florida)

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Please list your Name with roles, credentials, and FTE?

(e.g. Jane Doe, APRN, Clinical Pathway Director, 1 FTE)

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How many full time equivalents (FTE) does your hospital dedicate to clinical pathway development?

(e.g. 1 FTE Director, 2 FTE Program Manager, 0.3 FTE Medical Director)

What year was your pathway group established?

Where does your clinical pathway development department reside in your organization?

(e.g. Quality and Safety)