TY - JOUR
T1 - Development and implementation of a clinical pathway for patients undergoing total laryngectomy
T2 - Impact on cost and quality of care
AU - Hanna, Ehab
AU - Schultz, Susan
AU - Doctor, Donnella
AU - Vural, Emre
AU - Stern, Scott
AU - Suen, James
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 1999/11
Y1 - 1999/11
N2 - Background: The current health care climate demands the provision of quality patient care in a cost-effective manner. Clinical pathways define the essential components of care that are provided to patients with a specific diagnosis to achieve a desired outcome within a predetermined period. Development and implementation of clinical pathways streamline the provision of quality care in the most cost-effective manner. Objectives: To develop a clinical pathway for patients undergoing total laryngectomy and to evaluate its impact on the cost and quality of care provided to these patients. Selling: A tertiary care academic medical center. Patients and Methods: A total of 45 patients were included in the study. The clinical pathway was implemented for 15 patients, while the other 30 patients were treated without the implementation of the pathway guidelines. Main Outcome Measures: Length of hospital stay, readmission rate, and hospital variable costs. Results: The clinical pathway affected all cost outcome measures. Length of stay decreased by 2.4 days (29%; P = .001), and the average hospital variable cost decreased from $3992 to $3419 per case. This represents a 14.4% reduction in cost associated with pathway implementation (P = .02). The standardization of care eliminated unnecessary variation and repetition in resource usage, resulting in overall cost reduction. Pathway implementation resulted in a lower readmission rate (7% [1/15]) than that of patients treated prior to protocol implementation (23% [7/30]). Conclusion: Implementing a carefully developed clinical pathway may reduce cost without compromising the quality of care for patients undergoing total laryngectomy.
AB - Background: The current health care climate demands the provision of quality patient care in a cost-effective manner. Clinical pathways define the essential components of care that are provided to patients with a specific diagnosis to achieve a desired outcome within a predetermined period. Development and implementation of clinical pathways streamline the provision of quality care in the most cost-effective manner. Objectives: To develop a clinical pathway for patients undergoing total laryngectomy and to evaluate its impact on the cost and quality of care provided to these patients. Selling: A tertiary care academic medical center. Patients and Methods: A total of 45 patients were included in the study. The clinical pathway was implemented for 15 patients, while the other 30 patients were treated without the implementation of the pathway guidelines. Main Outcome Measures: Length of hospital stay, readmission rate, and hospital variable costs. Results: The clinical pathway affected all cost outcome measures. Length of stay decreased by 2.4 days (29%; P = .001), and the average hospital variable cost decreased from $3992 to $3419 per case. This represents a 14.4% reduction in cost associated with pathway implementation (P = .02). The standardization of care eliminated unnecessary variation and repetition in resource usage, resulting in overall cost reduction. Pathway implementation resulted in a lower readmission rate (7% [1/15]) than that of patients treated prior to protocol implementation (23% [7/30]). Conclusion: Implementing a carefully developed clinical pathway may reduce cost without compromising the quality of care for patients undergoing total laryngectomy.
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U2 - 10.1001/archotol.125.11.1247
DO - 10.1001/archotol.125.11.1247
M3 - Article
C2 - 10555697
AN - SCOPUS:0032743865
SN - 0886-4470
VL - 125
SP - 1247
EP - 1251
JO - Archives of Otolaryngology - Head and Neck Surgery
JF - Archives of Otolaryngology - Head and Neck Surgery
IS - 11
ER -