Introduction: Critical Care pathways are treatment plans which act as a timetable for the delivery of healthcare. They provide a benchmark for the care and outcomes of most patients and are particularly suited to high volume conditions with a relatively predictable clinical course. Traditionally they have arisen from consensus.

Objective: To develop and implement an evidence based CCP for the treatment of FNOF in two Northern Sydney Area Health Service acute hospitals. A long term objective was to have the pathway replace the notes for these patients.

Methods: Core best practice elements for the treatment of FNOF were derived from a Cochrane style systematic review. After considerable consultation with those staff involved with FNOF patients, two pathways which were site specific but retained the core best practice elements were piloted.

Results: The development of the core best practice elements was the easier phase of this study. The development of a CCP which retained these elements but was individual enough to be 'owned' by the hospitals involved, required negotiation and motivation skills and a considerable amount of time. We will present some results on the barriers and aids to implementation and how compliance with best practice has been monitored.