| Autor: |
O’Connell, Daniel, Barber, Brittany, Klein, Max, Soparlo, Jeff, Al-Marzouki, Hani, Harris, Jeffrey, Seikaly, Hadi |
| Zdroj: |
Journal of Otolaryngology - Head and Neck Surgery; December 2015, Vol. 44 Issue: 1 p1-5, 5p |
| Abstrakt: |
To determine if rigid adherence (where medically appropriate) to an algorithm/checklist-based patient care pathway can reduce the duration of hospitalization and complication rates in patients undergoing head and neck reconstruction with free tissue transfer. Study design was a retrospective case-control study of patients undergoing major head and neck cancer resections and reconstruction at a tertiary referral centre. The intervention was rigid adherence to a pre-existing care pathway including flow algorithms and multidisciplinary checklists incorporated into patient charting and care orders. 157 patients were enrolled prospectively and were compared to 99 patients in a historical cohort. Patient charts were reviewed and information related to the patient, procedure, and post-operative course was extracted. The two groups were compared for number of major and minor complications (using the Clavien-Dindo system) and length of stay in hospital. Comparing pre- and post-intervention groups, no significant difference was identified in duration of hospital stay (21.5 days vs. 20.5 days, p= 0.750), the rate of major complications was significantly higher in the pre-intervention cohort (25.3 % vs. 14.0 %, p= 0.031), the rate of minor complications was not significantly higher (34.3 % vs 30.8 %, p= 0.610). Rigid adherence to our patient care pathway, and improved charting techniques including flow algorithms and multidisciplinary checklists has improved patient care by showing a significant reduction in the rate of major complications. |
| Databáze: |
Supplemental Index |
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