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ABSTRACT: Introduction
Enhanced recovery pathways are standardized, multidisciplinary, consensus-based tools that provide guidelines for evidence-based decision-making. This study evaluates the impact of the implementation of a clinical care pathway on patient outcomes following radical prostatectomy in a universal healthcare system.Methods
Medical charts of 200 patients with prostate cancer who underwent open and minimally invasive radical prostatectomy at a single academic hospital from 2009 to 2012 were reviewed. A group of 100 consecutive patients' pre-pathway implementation was compared with 99 consecutive patients' post-pathway implementation. Duration of hospital stay, complications, post-discharge emergency department visits and readmissions were compared between the 2 groups.Results
Length of hospital stay decreased from a median of 3 (inter-quartile range [IQR] 4 to 3 days) days in the pre-pathway group to a median of 2 (IQR 3 to 2 days) days in the post-pathway group regardless of surgical approach (p < 0.0001). Complication rates, emergency department visits and hospital readmissions were not significantly different in the pre- and post-pathway groups (17% vs. 21%, p = 0.80; 12% vs. 12%, p = 0.95; and 3% vs. 7%, p = 0.18, respectively). These findings were consistent after stratification by surgical approach. Limitations of our study include lack of assessment of patient satisfaction, and the retrospective study design.Conclusions
The implementation of a standardized, multidisciplinary clinical care pathway for patients undergoing radical prostatectomy improved efficiency without increasing complication rates or hospital readmissions.
SUBMITTER: Abou-Haidar H
PROVIDER: S-EPMC4277521 | biostudies-literature | 2014 Nov
REPOSITORIES: biostudies-literature
Abou-Haidar Hiba H Abourbih Samuel S Braganza David D Qaoud Talal Al TA Lee Lawrence L Carli Franco F Watson Deborah D Aprikian Armen G AG Tanguay Simon S Feldman Liane S LS Kassouf Wassim W
Canadian Urological Association journal = Journal de l'Association des urologues du Canada 20141101 11-12
<h4>Introduction</h4>Enhanced recovery pathways are standardized, multidisciplinary, consensus-based tools that provide guidelines for evidence-based decision-making. This study evaluates the impact of the implementation of a clinical care pathway on patient outcomes following radical prostatectomy in a universal healthcare system.<h4>Methods</h4>Medical charts of 200 patients with prostate cancer who underwent open and minimally invasive radical prostatectomy at a single academic hospital from ...[more]