IMPROVEMENTS IN THE EFFICIENCY OF CARE AFTER IMPLEMENTING A CLINICAL-CARE PATHWAY FOR TRANSURETHRAL PROSTATECTOMY

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.