The changing demands of the health care environment require that more effective treatments be used to lower costs and decrease length of stay. Clinical pathways provide a detailed plan of care and are one method available to achieve these goals. The carotid endarterectomy pathway was selected as the first pathway developed because of the short length of stay and its history of few complications. The process of developing the pathway gave the multidisciplinary team a chance to rethink individual practices and rid themselves of old habits. The results showed a decreased length of stay, lower costs, and maintenance of high patient outcomes. The positive impact also required changes in teaching tools.