The effectiveness of a "critical pathway" in the management of laryngectomy patients

• Published in: Head & neck Vol. 22; no. 7; pp. 694 - 699
• Main Authors: Levin, Roger J., Ferraro, Richard E., Kodosky, Sharon R., Fedok, Fred G.
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 01.10.2000; John Wiley & Sons
• Subjects: Adult; Aged; Biological and medical sciences; Cost-Benefit Analysis; critical pathway; Critical Pathways - standards; Female; General aspects; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; laryngectomy; Laryngectomy - economics; Laryngectomy - standards; Length of Stay - statistics & numerical data; Male; Medical sciences; Middle Aged; Patient Care - economics; Patient Care - statistics & numerical data; Planification. Prevention (methods). Intervention. Evaluation; Postoperative Complications; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; Treatment Outcome; United States; North America; America; Human; Resource allocation; Duration; Hospitalization; ENT; Cost benefit analysis; Laryngectomy; Clinical management; Referential; Treatment; Surgery; Professional practice; ENT disease; Adult; Procedure; Application method; Larynx disease; Technique; Treatment planning; Public health; Comparative study
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/1097-0347(200010)22:7<694::AID-HED9>3.0.CO;2-0

Background This is a retrospective review of medical and financial records to test the hypothesis that the use of a critical pathway specifically designed for the management of laryngectomy patients will result in improved patient care, decreased length of hospitalization, and optimal allocation of resources. Methods Thirty patients undergoing laryngectomy before the implementation of the laryngectomy critical pathway were compared with 30 patients after implementation of the pathway. Clinical outcomes, length of hospitalization, and cost analyses were performed. Results Adjusting for two outliers, the average length of stay for pathway patients was 7.3 days vs 12 days for prepathway patients. A total estimated cost‐savings of $204,000 was ultimately achieved. Conclusions Our laryngectomy critical pathway has resulted in improved patient care and optimized allocation of medical resources. © 2000 John Wiley & Sons, Inc. Head Neck 22: 694–699, 2000.