PDF herunterladen
Methods Inf Med 2007; 46(05): 574-579
DOI: 10.1160/ME9059
Paper
Schattauer GmbH

Clinical Pathways in General Surgery

Development, Implementation, and Evaluation
S. Graeber
1   Institute of Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Homburg /Saar, Germany
,
S. Richter
2   Department of General Surgery, Abdominal and Vascular Surgery, and Pediatric Surgery, Saarland University Hospital, Homburg /Saar, Germany
,
J. Folz
1   Institute of Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Homburg /Saar, Germany
,
P.-T. Pham
1   Institute of Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Homburg /Saar, Germany
,
P. Jacob
2   Department of General Surgery, Abdominal and Vascular Surgery, and Pediatric Surgery, Saarland University Hospital, Homburg /Saar, Germany
,
M. K. Schilling
2   Department of General Surgery, Abdominal and Vascular Surgery, and Pediatric Surgery, Saarland University Hospital, Homburg /Saar, Germany
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
22. Januar 2018 (online)

   Lizenzen und Reprints

Summary

Objectives: To emphasize the importance of the view of business process management for development and implementation of clinical pathways, and to evaluate their effectiveness in reducing cost and effort as well as enhancing patient satisfaction.

Methods: We describe the development and implementation of pathways with methods of process management and the design and realization of an evaluation study in the setting of a surgical department. For this study 67 patients treated without clinical pathways were compared with 62 patients treated using pathways.

Results: The approach explicitly enhances the development and implementation of clinical pathways. The introduction of pathways reduces length of hospital stay, number of laboratory tests, number of consultations, and number of imaging procedures. Patient satisfaction is improved.

Conclusions: Depending on design and setting, the introduction of clinical pathways may be a very promising method to improve the inpatient service at a hospital and so to react to the challenges of increasing competition in medical care.

Keywords

Patient care planning - critical pathways - clinical pathways - process management - evaluation
 

  • References

  • 1 Matthews D. What is a clinical pathway?. J Am Coll Dent 2005; 72 (04) 32-36.
    PubMedSuche in Google Scholar
  • 2 Taylor WJ, Wong A, Siegert RJ, McNaughton HK. Effectiveness of a clinical pathway for acute stroke care in a district general hospital: an audit. BMC Health Serv Res. 2006: 6-16.
    PubMedSuche in Google Scholar
  • 3 Dy SM, Garg P, Nyberg D, Dawson PB, Pronovost PJ, Morlock L. et al. Critical pathway effectiveness: assessing the impact of patient, hospital care, and pathway characteristics using qualitative comparative analysis. Health Serv Res 2005; 40 (02) 311-315.
    CrossrefPubMedSuche in Google Scholar
  • 4 Becker K, Eckardt J. Grundlagen integrierter Behandlungspfade. Eckardt J, Sens B. Praxishandbuch integrierte Behandlungspfade.. Heidelberg: Economica; 2006: 39-64 (in German).
    Suche in Google Scholar
  • 5 Pearson SD, Goulart-Fisher D, Lee TH. Critical Pathways as a Strategy for Improving Care. Problems and Potential. Ann Intern Med 1995; 123 (12) 941-948.
    CrossrefPubMedSuche in Google Scholar
  • 6 www.ids-scheer.com/international/english/products/53961. Last access 2007-05-02.
    PubMed
  • 7 Schmidt J, Nübling R. ZUF-8. Fragebogen zur Messung der Patientenzufriedenheit. Brähler E, Schumacher J, Strauß B. Diagnostische Verfahren in der Psychotherapie.. Göttingen: Hogrefe; 2002: 392-396 (in German).
    Suche in Google Scholar
  • 8 Pearson SD, Kleefield SF, Soukop JR, Cook EF, Lee TH. Critical Pathways Intervention to Reduce Length of Hospital Stay. Am J Med 2001; 110 (03) 175-180.
    CrossrefPubMedSuche in Google Scholar
  • 9 Shiffman RN, Michel G, Essaihi A, Thornquist E. Bridging the Guideline Implementation Gap: A Systematic Document-Centered Approach to Guideline Implementation. J Am Med Inform Assoc 2003; 11 (05) 418-426.
    PubMedSuche in Google Scholar
  • 10 Brender J, Ammenwerth E, Nykänen P, Talmon J. Factors Influencing Success and Failure of Health Informatics Systems. Methods Inf Med 2006; 45: 125-136.
    Thieme ConnectPubMedSuche in Google Scholar
  • 11 Ash JS, Stavri PZ, Dykstra R, Fournier L. Implementing computerized physician order entry: the importance of special people. Int J Med Inform 2003; 69 2-3 235-250.
    CrossrefPubMedSuche in Google Scholar
  • 12 Lorenzi NM, Riley RT. Organizational issues = change. Int J Med Inform 2003; 69 2-3 197-203.
    CrossrefPubMedSuche in Google Scholar
  • 13 Brender J. Handbook of Evaluation Methods for Health Informatics.. Burlington: Elsevier Academic Press; 2006
  • 14 Melbert RB, Kimmins MH, Isler JT, Billingham RP, Lawton D, Salvadalena G. et al. Use of a critical pathway for colon resections. Gastrointest Surg 2002; 6 (05) 745-752.
    CrossrefPubMedSuche in Google Scholar