Compliance of Clinical Pathways in Elective Laparoscopic Cholecystectomy: Evaluation of Different Implementation Methods
Background Clinical pathways aim to standardize perioperative and postoperative care of surgical procedures and are shown to result in a significant optimization associated with cost reduction. The aim of this study was to establish the impact of two different implementations forms of clinical pathw...
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Gespeichert in:
| Autor*in: |
Holderried, Martin [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2016 |
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| Schlagwörter: |
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| Anmerkung: |
© Société Internationale de Chirurgie 2016 |
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| Übergeordnetes Werk: |
Enthalten in: World Journal of Surgery - Springer-Verlag, 1996, 40(2016), 12 vom: 18. Juli, Seite 2888-2891 |
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| Übergeordnetes Werk: |
volume:40 ; year:2016 ; number:12 ; day:18 ; month:07 ; pages:2888-2891 |
| Links: |
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| DOI / URN: |
10.1007/s00268-016-3645-4 |
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SPR003455459 |
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| 520 | |a Background Clinical pathways aim to standardize perioperative and postoperative care of surgical procedures and are shown to result in a significant optimization associated with cost reduction. The aim of this study was to establish the impact of two different implementations forms of clinical pathways on the pathway compliance and resulting costs. Methods Data of patients undergoing elective cholecystectomy for symptomatic cholecystolithiasis were collected over two different periods: using a clinical pathway in the form of a paper-based checklist, or a clinical pathway integrated into the paper-based medical treatment and nursing documentation. Outcome measures were compliance of the clinical pathway and total costs per case. Results The compliance was significantly higher using integrated pathways compared to paper-based checklists (n = 117 of 123, 95 % vs 54 of 118, 46 %; p < 0.001). Mean total costs (€2206 vs €2458, p = 0.027) and length of hospital stay (2.13 vs 2.77 days, p < 0.001) were significantly reduced by the integrated clinical pathway compared to checklists. Further, the variation of costs per case and variation of length of hospital stay were significantly smaller with integrated clinical pathway (±€440 vs ±€538, p = 0.039 and ±0.53 vs ±0.68 days, p < 0.001, respectively). No difference regarding postoperative complication was observed (n = 3 vs. 4 events; p = 0.67). Conclusion Integrated clinical pathways display a significant higher compliance compared to checklists resulting in reduced total costs, shorter hospital stay and a smaller variation of cost, making it a useful tool in process controlling and planning. | ||
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| 650 | 4 | |a Elective Laparoscopic Cholecystectomy |7 (dpeaa)DE-He213 | |
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| 700 | 1 | |a Falch, Claudius |4 aut | |
| 700 | 1 | |a Kirschniak, Andreas |4 aut | |
| 700 | 1 | |a Koenigsrainer, Alfred |4 aut | |
| 700 | 1 | |a Ernst, Christian |4 aut | |
| 700 | 1 | |a Muller, Sven |4 aut | |
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10.1007/s00268-016-3645-4 doi (DE-627)SPR003455459 (SPR)s00268-016-3645-4-e DE-627 ger DE-627 rakwb eng Holderried, Martin verfasserin aut Compliance of Clinical Pathways in Elective Laparoscopic Cholecystectomy: Evaluation of Different Implementation Methods 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2016 Background Clinical pathways aim to standardize perioperative and postoperative care of surgical procedures and are shown to result in a significant optimization associated with cost reduction. The aim of this study was to establish the impact of two different implementations forms of clinical pathways on the pathway compliance and resulting costs. Methods Data of patients undergoing elective cholecystectomy for symptomatic cholecystolithiasis were collected over two different periods: using a clinical pathway in the form of a paper-based checklist, or a clinical pathway integrated into the paper-based medical treatment and nursing documentation. Outcome measures were compliance of the clinical pathway and total costs per case. Results The compliance was significantly higher using integrated pathways compared to paper-based checklists (n = 117 of 123, 95 % vs 54 of 118, 46 %; p < 0.001). Mean total costs (€2206 vs €2458, p = 0.027) and length of hospital stay (2.13 vs 2.77 days, p < 0.001) were significantly reduced by the integrated clinical pathway compared to checklists. Further, the variation of costs per case and variation of length of hospital stay were significantly smaller with integrated clinical pathway (±€440 vs ±€538, p = 0.039 and ±0.53 vs ±0.68 days, p < 0.001, respectively). No difference regarding postoperative complication was observed (n = 3 vs. 4 events; p = 0.67). Conclusion Integrated clinical pathways display a significant higher compliance compared to checklists resulting in reduced total costs, shorter hospital stay and a smaller variation of cost, making it a useful tool in process controlling and planning. Clinical Pathway (dpeaa)DE-He213 Pathway Form (dpeaa)DE-He213 Nursing Workload (dpeaa)DE-He213 Elective Laparoscopic Cholecystectomy (dpeaa)DE-He213 Psychologic Ownership (dpeaa)DE-He213 Hummel, Rebecca aut Falch, Claudius aut Kirschniak, Andreas aut Koenigsrainer, Alfred aut Ernst, Christian aut Muller, Sven aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 40(2016), 12 vom: 18. Juli, Seite 2888-2891 (DE-627)SPR003391159 nnns volume:40 year:2016 number:12 day:18 month:07 pages:2888-2891 https://dx.doi.org/10.1007/s00268-016-3645-4 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 40 2016 12 18 07 2888-2891 |
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10.1007/s00268-016-3645-4 doi (DE-627)SPR003455459 (SPR)s00268-016-3645-4-e DE-627 ger DE-627 rakwb eng Holderried, Martin verfasserin aut Compliance of Clinical Pathways in Elective Laparoscopic Cholecystectomy: Evaluation of Different Implementation Methods 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2016 Background Clinical pathways aim to standardize perioperative and postoperative care of surgical procedures and are shown to result in a significant optimization associated with cost reduction. The aim of this study was to establish the impact of two different implementations forms of clinical pathways on the pathway compliance and resulting costs. Methods Data of patients undergoing elective cholecystectomy for symptomatic cholecystolithiasis were collected over two different periods: using a clinical pathway in the form of a paper-based checklist, or a clinical pathway integrated into the paper-based medical treatment and nursing documentation. Outcome measures were compliance of the clinical pathway and total costs per case. Results The compliance was significantly higher using integrated pathways compared to paper-based checklists (n = 117 of 123, 95 % vs 54 of 118, 46 %; p < 0.001). Mean total costs (€2206 vs €2458, p = 0.027) and length of hospital stay (2.13 vs 2.77 days, p < 0.001) were significantly reduced by the integrated clinical pathway compared to checklists. Further, the variation of costs per case and variation of length of hospital stay were significantly smaller with integrated clinical pathway (±€440 vs ±€538, p = 0.039 and ±0.53 vs ±0.68 days, p < 0.001, respectively). No difference regarding postoperative complication was observed (n = 3 vs. 4 events; p = 0.67). Conclusion Integrated clinical pathways display a significant higher compliance compared to checklists resulting in reduced total costs, shorter hospital stay and a smaller variation of cost, making it a useful tool in process controlling and planning. Clinical Pathway (dpeaa)DE-He213 Pathway Form (dpeaa)DE-He213 Nursing Workload (dpeaa)DE-He213 Elective Laparoscopic Cholecystectomy (dpeaa)DE-He213 Psychologic Ownership (dpeaa)DE-He213 Hummel, Rebecca aut Falch, Claudius aut Kirschniak, Andreas aut Koenigsrainer, Alfred aut Ernst, Christian aut Muller, Sven aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 40(2016), 12 vom: 18. Juli, Seite 2888-2891 (DE-627)SPR003391159 nnns volume:40 year:2016 number:12 day:18 month:07 pages:2888-2891 https://dx.doi.org/10.1007/s00268-016-3645-4 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 40 2016 12 18 07 2888-2891 |
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10.1007/s00268-016-3645-4 doi (DE-627)SPR003455459 (SPR)s00268-016-3645-4-e DE-627 ger DE-627 rakwb eng Holderried, Martin verfasserin aut Compliance of Clinical Pathways in Elective Laparoscopic Cholecystectomy: Evaluation of Different Implementation Methods 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2016 Background Clinical pathways aim to standardize perioperative and postoperative care of surgical procedures and are shown to result in a significant optimization associated with cost reduction. The aim of this study was to establish the impact of two different implementations forms of clinical pathways on the pathway compliance and resulting costs. Methods Data of patients undergoing elective cholecystectomy for symptomatic cholecystolithiasis were collected over two different periods: using a clinical pathway in the form of a paper-based checklist, or a clinical pathway integrated into the paper-based medical treatment and nursing documentation. Outcome measures were compliance of the clinical pathway and total costs per case. Results The compliance was significantly higher using integrated pathways compared to paper-based checklists (n = 117 of 123, 95 % vs 54 of 118, 46 %; p < 0.001). Mean total costs (€2206 vs €2458, p = 0.027) and length of hospital stay (2.13 vs 2.77 days, p < 0.001) were significantly reduced by the integrated clinical pathway compared to checklists. Further, the variation of costs per case and variation of length of hospital stay were significantly smaller with integrated clinical pathway (±€440 vs ±€538, p = 0.039 and ±0.53 vs ±0.68 days, p < 0.001, respectively). No difference regarding postoperative complication was observed (n = 3 vs. 4 events; p = 0.67). Conclusion Integrated clinical pathways display a significant higher compliance compared to checklists resulting in reduced total costs, shorter hospital stay and a smaller variation of cost, making it a useful tool in process controlling and planning. Clinical Pathway (dpeaa)DE-He213 Pathway Form (dpeaa)DE-He213 Nursing Workload (dpeaa)DE-He213 Elective Laparoscopic Cholecystectomy (dpeaa)DE-He213 Psychologic Ownership (dpeaa)DE-He213 Hummel, Rebecca aut Falch, Claudius aut Kirschniak, Andreas aut Koenigsrainer, Alfred aut Ernst, Christian aut Muller, Sven aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 40(2016), 12 vom: 18. Juli, Seite 2888-2891 (DE-627)SPR003391159 nnns volume:40 year:2016 number:12 day:18 month:07 pages:2888-2891 https://dx.doi.org/10.1007/s00268-016-3645-4 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 40 2016 12 18 07 2888-2891 |
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10.1007/s00268-016-3645-4 doi (DE-627)SPR003455459 (SPR)s00268-016-3645-4-e DE-627 ger DE-627 rakwb eng Holderried, Martin verfasserin aut Compliance of Clinical Pathways in Elective Laparoscopic Cholecystectomy: Evaluation of Different Implementation Methods 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2016 Background Clinical pathways aim to standardize perioperative and postoperative care of surgical procedures and are shown to result in a significant optimization associated with cost reduction. The aim of this study was to establish the impact of two different implementations forms of clinical pathways on the pathway compliance and resulting costs. Methods Data of patients undergoing elective cholecystectomy for symptomatic cholecystolithiasis were collected over two different periods: using a clinical pathway in the form of a paper-based checklist, or a clinical pathway integrated into the paper-based medical treatment and nursing documentation. Outcome measures were compliance of the clinical pathway and total costs per case. Results The compliance was significantly higher using integrated pathways compared to paper-based checklists (n = 117 of 123, 95 % vs 54 of 118, 46 %; p < 0.001). Mean total costs (€2206 vs €2458, p = 0.027) and length of hospital stay (2.13 vs 2.77 days, p < 0.001) were significantly reduced by the integrated clinical pathway compared to checklists. Further, the variation of costs per case and variation of length of hospital stay were significantly smaller with integrated clinical pathway (±€440 vs ±€538, p = 0.039 and ±0.53 vs ±0.68 days, p < 0.001, respectively). No difference regarding postoperative complication was observed (n = 3 vs. 4 events; p = 0.67). Conclusion Integrated clinical pathways display a significant higher compliance compared to checklists resulting in reduced total costs, shorter hospital stay and a smaller variation of cost, making it a useful tool in process controlling and planning. Clinical Pathway (dpeaa)DE-He213 Pathway Form (dpeaa)DE-He213 Nursing Workload (dpeaa)DE-He213 Elective Laparoscopic Cholecystectomy (dpeaa)DE-He213 Psychologic Ownership (dpeaa)DE-He213 Hummel, Rebecca aut Falch, Claudius aut Kirschniak, Andreas aut Koenigsrainer, Alfred aut Ernst, Christian aut Muller, Sven aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 40(2016), 12 vom: 18. Juli, Seite 2888-2891 (DE-627)SPR003391159 nnns volume:40 year:2016 number:12 day:18 month:07 pages:2888-2891 https://dx.doi.org/10.1007/s00268-016-3645-4 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 40 2016 12 18 07 2888-2891 |
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10.1007/s00268-016-3645-4 doi (DE-627)SPR003455459 (SPR)s00268-016-3645-4-e DE-627 ger DE-627 rakwb eng Holderried, Martin verfasserin aut Compliance of Clinical Pathways in Elective Laparoscopic Cholecystectomy: Evaluation of Different Implementation Methods 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2016 Background Clinical pathways aim to standardize perioperative and postoperative care of surgical procedures and are shown to result in a significant optimization associated with cost reduction. The aim of this study was to establish the impact of two different implementations forms of clinical pathways on the pathway compliance and resulting costs. Methods Data of patients undergoing elective cholecystectomy for symptomatic cholecystolithiasis were collected over two different periods: using a clinical pathway in the form of a paper-based checklist, or a clinical pathway integrated into the paper-based medical treatment and nursing documentation. Outcome measures were compliance of the clinical pathway and total costs per case. Results The compliance was significantly higher using integrated pathways compared to paper-based checklists (n = 117 of 123, 95 % vs 54 of 118, 46 %; p < 0.001). Mean total costs (€2206 vs €2458, p = 0.027) and length of hospital stay (2.13 vs 2.77 days, p < 0.001) were significantly reduced by the integrated clinical pathway compared to checklists. Further, the variation of costs per case and variation of length of hospital stay were significantly smaller with integrated clinical pathway (±€440 vs ±€538, p = 0.039 and ±0.53 vs ±0.68 days, p < 0.001, respectively). No difference regarding postoperative complication was observed (n = 3 vs. 4 events; p = 0.67). Conclusion Integrated clinical pathways display a significant higher compliance compared to checklists resulting in reduced total costs, shorter hospital stay and a smaller variation of cost, making it a useful tool in process controlling and planning. Clinical Pathway (dpeaa)DE-He213 Pathway Form (dpeaa)DE-He213 Nursing Workload (dpeaa)DE-He213 Elective Laparoscopic Cholecystectomy (dpeaa)DE-He213 Psychologic Ownership (dpeaa)DE-He213 Hummel, Rebecca aut Falch, Claudius aut Kirschniak, Andreas aut Koenigsrainer, Alfred aut Ernst, Christian aut Muller, Sven aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 40(2016), 12 vom: 18. Juli, Seite 2888-2891 (DE-627)SPR003391159 nnns volume:40 year:2016 number:12 day:18 month:07 pages:2888-2891 https://dx.doi.org/10.1007/s00268-016-3645-4 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 40 2016 12 18 07 2888-2891 |
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Compliance of Clinical Pathways in Elective Laparoscopic Cholecystectomy: Evaluation of Different Implementation Methods |
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Compliance of Clinical Pathways in Elective Laparoscopic Cholecystectomy: Evaluation of Different Implementation Methods |
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Holderried, Martin |
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World Journal of Surgery |
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Holderried, Martin Hummel, Rebecca Falch, Claudius Kirschniak, Andreas Koenigsrainer, Alfred Ernst, Christian Muller, Sven |
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Holderried, Martin |
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10.1007/s00268-016-3645-4 |
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compliance of clinical pathways in elective laparoscopic cholecystectomy: evaluation of different implementation methods |
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Compliance of Clinical Pathways in Elective Laparoscopic Cholecystectomy: Evaluation of Different Implementation Methods |
| abstract |
Background Clinical pathways aim to standardize perioperative and postoperative care of surgical procedures and are shown to result in a significant optimization associated with cost reduction. The aim of this study was to establish the impact of two different implementations forms of clinical pathways on the pathway compliance and resulting costs. Methods Data of patients undergoing elective cholecystectomy for symptomatic cholecystolithiasis were collected over two different periods: using a clinical pathway in the form of a paper-based checklist, or a clinical pathway integrated into the paper-based medical treatment and nursing documentation. Outcome measures were compliance of the clinical pathway and total costs per case. Results The compliance was significantly higher using integrated pathways compared to paper-based checklists (n = 117 of 123, 95 % vs 54 of 118, 46 %; p < 0.001). Mean total costs (€2206 vs €2458, p = 0.027) and length of hospital stay (2.13 vs 2.77 days, p < 0.001) were significantly reduced by the integrated clinical pathway compared to checklists. Further, the variation of costs per case and variation of length of hospital stay were significantly smaller with integrated clinical pathway (±€440 vs ±€538, p = 0.039 and ±0.53 vs ±0.68 days, p < 0.001, respectively). No difference regarding postoperative complication was observed (n = 3 vs. 4 events; p = 0.67). Conclusion Integrated clinical pathways display a significant higher compliance compared to checklists resulting in reduced total costs, shorter hospital stay and a smaller variation of cost, making it a useful tool in process controlling and planning. © Société Internationale de Chirurgie 2016 |
| abstractGer |
Background Clinical pathways aim to standardize perioperative and postoperative care of surgical procedures and are shown to result in a significant optimization associated with cost reduction. The aim of this study was to establish the impact of two different implementations forms of clinical pathways on the pathway compliance and resulting costs. Methods Data of patients undergoing elective cholecystectomy for symptomatic cholecystolithiasis were collected over two different periods: using a clinical pathway in the form of a paper-based checklist, or a clinical pathway integrated into the paper-based medical treatment and nursing documentation. Outcome measures were compliance of the clinical pathway and total costs per case. Results The compliance was significantly higher using integrated pathways compared to paper-based checklists (n = 117 of 123, 95 % vs 54 of 118, 46 %; p < 0.001). Mean total costs (€2206 vs €2458, p = 0.027) and length of hospital stay (2.13 vs 2.77 days, p < 0.001) were significantly reduced by the integrated clinical pathway compared to checklists. Further, the variation of costs per case and variation of length of hospital stay were significantly smaller with integrated clinical pathway (±€440 vs ±€538, p = 0.039 and ±0.53 vs ±0.68 days, p < 0.001, respectively). No difference regarding postoperative complication was observed (n = 3 vs. 4 events; p = 0.67). Conclusion Integrated clinical pathways display a significant higher compliance compared to checklists resulting in reduced total costs, shorter hospital stay and a smaller variation of cost, making it a useful tool in process controlling and planning. © Société Internationale de Chirurgie 2016 |
| abstract_unstemmed |
Background Clinical pathways aim to standardize perioperative and postoperative care of surgical procedures and are shown to result in a significant optimization associated with cost reduction. The aim of this study was to establish the impact of two different implementations forms of clinical pathways on the pathway compliance and resulting costs. Methods Data of patients undergoing elective cholecystectomy for symptomatic cholecystolithiasis were collected over two different periods: using a clinical pathway in the form of a paper-based checklist, or a clinical pathway integrated into the paper-based medical treatment and nursing documentation. Outcome measures were compliance of the clinical pathway and total costs per case. Results The compliance was significantly higher using integrated pathways compared to paper-based checklists (n = 117 of 123, 95 % vs 54 of 118, 46 %; p < 0.001). Mean total costs (€2206 vs €2458, p = 0.027) and length of hospital stay (2.13 vs 2.77 days, p < 0.001) were significantly reduced by the integrated clinical pathway compared to checklists. Further, the variation of costs per case and variation of length of hospital stay were significantly smaller with integrated clinical pathway (±€440 vs ±€538, p = 0.039 and ±0.53 vs ±0.68 days, p < 0.001, respectively). No difference regarding postoperative complication was observed (n = 3 vs. 4 events; p = 0.67). Conclusion Integrated clinical pathways display a significant higher compliance compared to checklists resulting in reduced total costs, shorter hospital stay and a smaller variation of cost, making it a useful tool in process controlling and planning. © Société Internationale de Chirurgie 2016 |
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