Enhanced recovery pathway for radical prostatectomy: Implementation and evaluation in a universal healthcare system
| Autor: | Samuel Abourbih, Armen Aprikian, David Braganza, Liane S. Feldman, Talal Al Qaoud, Franco Carli, Wassim Kassouf, Simon Tanguay, Hiba Abou-Haidar, Deborah Watson, Lawrence Lee |
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| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
business.industry Prostatectomy Urology medicine.medical_treatment Retrospective cohort study Emergency department medicine.disease Surgery Prostate cancer Patient satisfaction Oncology Interquartile range Emergency medicine Medicine Complication business Original Research Healthcare system |
| Zdroj: | Canadian Urological Association Journal. 8:418 |
| ISSN: | 1920-1214 1911-6470 |
| DOI: | 10.5489/cuaj.2114 |
| Popis: | 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 (interquartile 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. |
| Databáze: | OpenAIRE |
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