OUTCOMES IN ABDOMINAL HYSTERECTOMY PATIENTS WITH BENIGN DISEASE - USEOF PHYSICIAN-DEVELOPED CLINICAL PROTOCOLS

OBJECTIVE: To develop a clinical protocol for standardizing preoperati ve and postoperative care in abdominal hysterectomy patients with beni gn disease while maintaining quality and increasing efficiency. STUDY DESIGN: Protocol and nonprotocol groups of patients were compared with respect to key quality and efficiency outcomes in an nonrandomized st udy. Patient group outcomes were compared using descriptive, Student's t, chi(2) and log-rank statistics. Statistical tests were performed a t a .05 level of significance. RESULTS: Results from two separate prot ocol study periods conducted in 1996 and 1997 are reported. In both st udy periods statistical analyses and graphic presentations illustrate that protocol implementation improved quality of care by increasing th e percentage of patients receiving appropriate antibiotic prophylaxis; maintained quality as monitored thorough 30-day readmission rates and a postdischarge patent survey; and improved efficiency, as evidenced by shorter times to incision and length of hospital stay. CONCLUSION: At Toledo Hospital, the clinical practice protocol directed at abdomin al hysterectomy patients has been an effective tool in efforts to impr ove quality and efficiency in patient care.