Objectives: A critical pathway was applied to patients undergoing osteoplas
tic Bap (OPF) for frontal sinus obliteration to determine whether efficienc
y could be improved. Study Design: A retrospective review of consecutive OF
F procedures (n = 51) performed between 1992 and July 1997 was conducted. M
ethods: The patient groups were subdivided into those who underwent OFF alo
ne and those who had endoscopic sinus procedures performed in addition to O
FF. Comparisons were made between the precritical pathway and post-critical
pathway groups, specifically noting operative time, total operating room (
OR) time, estimated blood loss (EBL), length of hospital stay, and costs. W
e used a critical pathway that was developed for endoscopic sinus procedure
s at our institution through a multidisciplinary team approach. Preoperativ
e evaluation and testing intraoperative equipment and medications, and post
operative care including follow-up clinic visits were all standardized, An
unpaired, two-tailed Student t test was used to evaluate the data. Results:
Statistically significant (P <.05) reductions in operative times, total OR
time, EEL, and length of hospital stay were observed in the post-critical
pathway group who underwent endoscopic sinus procedures as well as OFF. Cos
ts to the OR were reduced 29% and 15% for OFF and for OFF with endoscopic s
urgery, respectively. Patient costs were reduced 5% and 4% in these groups,
respectively. Conclusions: With implementation of effective critical pathw
ays, significant decreases in length of stay are seen, and cost reductions
can be realized through the improved efficiency, shortened OR times, and de
creases in redundancy of ordering materials.