The Effects of the Critical Pathway for Inguinal Hernia Repair

Abstract

This study was conducted to develop a case management program using the critical pathway (CP) as an intervention method for patients with an inguinal hernia for a herniorrhaphy, and to determine the effects of the CP on the period of hospitalization, medical costs, the rates of postoperative complaints, patient satisfaction and the nurses' job satisfaction. One hundred patients (60 in the experimental group, 40 in the control group) who were admitted to a general hospital in Seoul for inguinal herniorrhaphy were enrolled in this study. The results showed that the period of hospitalization and the postoperative hospital stay were significantly reduced in the CP group. In addition, the total medical cost, was lowered significantly by use of the CP for patients undergoing an inguinal herniorrhaphy. The rates of postoperative complaints, patients' satisfaction and the information on the treatment were enhanced after implementing the CP. These results suggests that the CP may be a useful tool for enhancing the health care outcome by decreasing the period of hospitalization, overall medical costs and by improving the quality of care, all of which can benefit the patients, the patients' family, caregivers and the hospital.

Efficacy of a clinical pathway for patients with thyroid cancer

“…A recent systematic review indicated that clinical pathways are associated with reductions in hospital length of stay and costs. [26][27][28] A recent study suggested nurses had a greater than expected impact on the success of clinical pathway implementation. Implementation of a clinical pathway in Singapore significantly reduced the length of stay from 3.3 to 1.9 days (P < .001) and hospital charges from S$3929 to S$3524 (P 5 .003).…”

Defining pathways

“…We choose for the consensus method because of the variety of meanings of the different terms. We decided to delete the term measurement, as defined by Joh (Joh et al. 2003), because its meaning in this context was confusing and ambiguous.…”

Clinical Pathways in surgery—should we introduce them into clinical routine? A review article

“…The study failed to demonstrate any significant effect between staff in whose ward the Pathway was introduced and those where this was not the case. Due to a low number of interviewed staff, however, the power of the study was low [20]. A small pilot study assessing the implementation of Clinical Pathways in vascular surgery showed that staff in general had a positive attitude towards the project and found that they were useful for training, for a more collective work and for patient-clinician communication.…”

“…The effects of Clinical Pathways on patients' satisfaction have not been extensively explored, but there are some studies providing pertinent evidence. Comparisons between pre-and post-pathway care yielded significant increases in patients' satisfaction for colon resections [14] and caesarean sections [40] and a non-significant increase for inguinal hernia repair [20]. Other studies assessed patients' satisfaction after Clinical Pathway introduction without using a comparison group of pre-pathway patients.…”

“…Such evidence exists for nearly all surgical subspecialties, and within the subspecialties for complex, as well as simpler, interventions (see also Table 1). In visceral surgery, among others, cost savings have been shown for colorectal surgery [14][15][16], pancreaticoduodenectomy [17], hepaticojejunostomy [18], oesophagectomy [19], inguinal hernia repair [20], appendectomy [21][22][23], thyroidectomy [24], parathyreoidectomy [25] and several laparoscopic [26] and bariatric procedures [27]. Furthermore, treatment with clinical pathways leads to cost reduction in liver [28] and kidney transplantation [29].…”