Pl. Chang et al., IMPROVEMENTS IN THE EFFICIENCY OF CARE AFTER IMPLEMENTING A CLINICAL-CARE PATHWAY FOR TRANSURETHRAL PROSTATECTOMY, British Journal of Urology, 81(3), 1998, pp. 394-397
Objective To investigate the efficiency of care, length of hospital st
ay and admission charges after implementing a clinical-care pathway fo
r transurethral prostatectomy (TURF). Patients and methods Changes in
the length of hospital stay and admission charges were identified by c
omparing a series of 100 patients undergoing TURF and treated after im
plementing a clinical-care pathway with 100 patients treated by the sa
me physicians before implementation. Results After implementing the ca
re pathway, the mean length of hospital stay and admission charges wer
e significantly lower (P < 0.01). The shorter length of stay was cause
d by a significant reduction (P < 0.05) in patient-related psychologic
al/social delay after implementation. The number of laboratory tests a
nd use of pharmacological agents were also significantly lower (P < 0.
001) after implementation, with the decreases in these last variables
significantly greater (P < 0.001) among junior physicians. Conclusions
The advantages of the TURF clinical-care pathway were the shorter hos
pital stay, arising from reduced patient-related psychological or soci
al delay, and reduced admission charges consequent on the decreased us
e of laboratory tests and drugs, particularly for patients treated by
junior physicians. These results suggest that physicians are likely to
modify their management methods to improve efficiency when a clinical
path is implemented.