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In 1990, The Memorial Hospital at Easton, Maryland, Inc., a not-for-profit 183-bed rural community hospital, recognized a need to explore alternative patient care methods or approaches to improve the continuity of care, focus on healthier patient outcomes, and contain costs. The concept of collaborative care became the focus for patient care delivery. Multidisciplinary teams were established to coordinate patient care activities for patient populations identified through the total quality management/continuous quality improvement process. Plans of care, referred to as critical pathways, identify intermediate goals and interventions, providing guidance for the patient, family, and healthcare providers as they work to achieve quality outcomes. As the patient progresses along the critical pathway, variances from the established goals are monitored and become the focus of quality reviews.