BACKGROUND: A systematic review on clinical pathways for gastrointestinal surgery was performed. The aim was to study indicators that are used to evaluate these clinical pathways and to study which effects of clinical pathways are reported. METHODS: A search was performed for the period from January 2000 to November 2006 in MEDLINE, EMBASE and CINAHL. The Leuven Clinical Pathway Compass was used to categorize the indicators reported in literature. RESULTS: Twenty-three studies were selected, of which 16 were controlled studies. The studies assessed most frequently complication rates, re-admissions, mortality and length of stay. More specific indicators like time to start defecation and time to return to enteral feeding were reported as well. None of the studies reported adverse effects in any of the domains of the Clinical Pathway Compass. CONCLUSION: Clinical pathways for gastrointestinal surgery can enhance efficiency of care without adverse effects on outcome. Specific indicators to evaluate these clinical pathways are time to return to enteral feeding and time to defecate. Furthermore, additional to complication rates, number of re-admissions, mortality and length of stay, indicators such as the number of re-operations, pain scores and intensive care unit admission can be assessed to monitor effectiveness and patient safety of the clinical pathways.
BACKGROUND: A systematic review on clinical pathways for gastrointestinal surgery was performed. The aim was to study indicators that are used to evaluate these clinical pathways and to study which effects of clinical pathways are reported. METHODS: A search was performed for the period from January 2000 to November 2006 in MEDLINE, EMBASE and CINAHL. The Leuven Clinical Pathway Compass was used to categorize the indicators reported in literature. RESULTS: Twenty-three studies were selected, of which 16 were controlled studies. The studies assessed most frequently complication rates, re-admissions, mortality and length of stay. More specific indicators like time to start defecation and time to return to enteral feeding were reported as well. None of the studies reported adverse effects in any of the domains of the Clinical Pathway Compass. CONCLUSION: Clinical pathways for gastrointestinal surgery can enhance efficiency of care without adverse effects on outcome. Specific indicators to evaluate these clinical pathways are time to return to enteral feeding and time to defecate. Furthermore, additional to complication rates, number of re-admissions, mortality and length of stay, indicators such as the number of re-operations, pain scores and intensive care unit admission can be assessed to monitor effectiveness and patient safety of the clinical pathways.
Authors: Marion van der Kolk; Mark van den Boogaard; Femke Becking-Verhaar; Hettie Custers; Hans van der Hoeven; Peter Pickkers; Kees van Laarhoven Journal: J Gastrointest Surg Date: 2017-06-06 Impact factor: 3.452
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Authors: Kris Vanhaecht; Walter Sermeus; Jan Peers; Cathy Lodewijckx; Svin Deneckere; Fabrizio Leigheb; Steven Boonen; An Sermon; Paulo Boto; Rita Veloso Mendes; Massimiliano Panella Journal: BMC Health Serv Res Date: 2012-05-24 Impact factor: 2.655
Authors: Roberto Latina; Katia Salomone; Daniela D'Angelo; Daniela Coclite; Greta Castellini; Silvia Gianola; Alice Fauci; Antonello Napoletano; Laura Iacorossi; Primiano Iannone Journal: Int J Environ Res Public Health Date: 2020-11-20 Impact factor: 3.390
Authors: Alice C Wei; David R Urbach; Katharine S Devitt; Meagan Wiebe; Oliver F Bathe; Robin S McLeod; Erin D Kennedy; Nancy N Baxter Journal: BMC Surg Date: 2014-07-19 Impact factor: 2.102