title: Outcomes in abdominal hysterectomy patients with benign disease. Use of physician-developed clinical protocols.
abstract: OBJECTIVE
  To develop a clinical protocol for standardizing preoperative and postoperative care in abdominal hysterectomy patients with benign disease while maintaining quality and increasing efficiency.
  
  
  METHODS
  Protocol and nonprotocol groups of patients were compared with respect to key quality and efficiency outcomes in a non-randomized study. Patient group outcomes were compared using descriptive, Student's t, chi 2 and log-rank statistics. Statistical tests were performed at a .05 level of significance.
  
  
  RESULTS
  Results from two separate protocol study periods conducted in 1996 and 1997 are reported. In both study periods statistical analyses and graphic presentations illustrate that protocol implementation improved quality of care by increasing the percentage of patients receiving appropriate antibiotic prophylaxis; maintained quality as monitored through 30-day readmission rates and a postdischarge patient survey; and improved efficiency, as evidenced by shorter times to incision and length of hospital stay.
  
  
  CONCLUSIONS
  At Toledo Hospital, the clinical practice protocol directed at abdominal hysterectomy patients has been an effective tool in efforts to improve quality and efficiency in patient care.
authors.affiliation: Department of Obstetrics and Gynecology, Toledo Hospital, OH 43606, USA.
authors.forename: L O
authors.initials: LO
authors.lastname: D'Amato
authors.forename: L A
authors.initials: LA
authors.lastname: Talmage
authors.forename: K
authors.initials: K
authors.lastname: Hyde
authors.forename: S
authors.initials: S
authors.lastname: McKnight
authors.forename: P
authors.initials: P
authors.lastname: Vandenbusche
mesh_terms: D002985:Clinical Protocols; D019091:Critical Pathways / Q000592:standards*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods / Q000592:standards*; D007902:Length of Stay / Q000706:statistics & numerical data; D009775:Obstetrics and Gynecology Department, Hospital / Q000592:standards*; D009820:Ohio; D010359:Patient Readmission / Q000706:statistics & numerical data; D011182:Postoperative Care / Q000379:methods / Q000592:standards; D011300:Preoperative Care / Q000379:methods / Q000592:standards; D011785:Quality Assurance, Health Care / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome