title: Clinical pathways in acoustic tumor management.
abstract: Clinical pathways are tools for cost containment and quality improvement in the managed care environment. This report describes our experience with developing and implementing a clinical pathway for acoustic neuroma surgery. Intensive care unit bed days and inpatient hospitalization days for cerebellopontine angle surgery significantly decreased during the months that the pathway was developed, and the incidence of complications was unchanged after adoption of the algorithm. We conclude that with joint neurootology and neurosurgery leadership clinical pathways can be a safe, cost-effective, and clinically useful technique in acoustic neuroma surgery in a managed care setting. As this management scheme evolves, surgeons must take the leadership to ensure that decisions are based on clinically relevant parameters.
authors.affiliation: Allegheny Neuroscience Institute and Pittsburgh Ear Associates, PA 15212, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Arriaga
authors.forename: M
authors.initials: M
authors.lastname: Gorum
authors.forename: A
authors.initials: A
authors.lastname: Kennedy
mesh_terms: D000465:Algorithms; D003363:Cost Control; D003362:Cost-Benefit Analysis; D019091:Critical Pathways / Q000458:organization & administration*; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008329:Managed Care Programs / Q000458:organization & administration / Q000592:standards*; D009464:Neuroma, Acoustic / Q000191:economics / Q000601:surgery*; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team; D010414:Pennsylvania; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies