Effects of a clinical pathway of pulmonary lobectomy and bilobectomy on quality and cost of care

Abstract

After CP implementation for open lobectomy the quality and standardization of care improved. Although length of hospital stay was significantly reduced, there was no significant increase of re-admissions or morbidity. Patients benefited from a shortened hospital stay while the hospital achieved cost reduction. This early analysis shows that the implementation of CP for open lobectomy has positive effects in terms of quality and cost of care.

The European initiative for quality management in lung cancer care

“…In two independent studies by SALATI et al [44] and SCHWARZBACH et al [45], the implementation of a clinical pathway for thoracic surgery led to a reduction of hospital stay without negatively influencing readmission rates. AVELING et al [46] described 30 paired MDTs performing reciprocal peer-review visits, to try and identify elements of good practice and encourage reflective analysis.…”

A clinical audit in a multidisciplinary care path for thoracic surgery: An instrument for continuous quality improvement

“…Like for many cancer procedures, there are several reports on the beneficial effects of standardized clinical pathways for thoracic surgery [3,4,8]. It is stated that the vast majority of patients candidate for pulmonary resection, even those at high risk, can receive safe and efficient peri-operative care by way of preset algorithms [12].…”

“…More advanced surgical and anaesthesiological techniques and better preoperative evaluation have reduced immediate postoperative risks and have extended surgical options for more compromised patients [7]. In addition, it has been suggested that fast-track care paths reduce length of stay and costs of lung resections [8,3,9].…”

Surgical intensive care unit – essential for good outcome in major abdominal surgery?

“…Their implementation into intensive care may ensure that defined, evidence-based standards are transferred to the patient's bedside and may reduce the variability in clinical practice, especially for more complex abdominal surgery where the postoperative risk of complications is high. Schwarzbach et al evaluated the effects of clinical pathways in kidney transplantation and pulmonary surgery on quality of care and confirmed an improvement of process quality, such as control of cyclosporine levels, catheter removal, and respiratory exercising [93][94][95]. In a systematic review, Lemmens et al analyzed the content of clinical pathways for digestive surgery and their effects on postoperative outcome measures [96].…”