The effectiveness of a "critical pathway" in the management of laryngectomy patients.
BACKGROUND
This is a retrospective review of medical and financial records to test the hypothesis that the use of a critical pathway specifically designed for the management of laryngectomy patients will result in improved patient care, decreased length of hospitalization, and optimal allocation of resources.


METHODS
Thirty patients undergoing laryngectomy before the implementation of the laryngectomy critical pathway were compared with 30 patients after implementation of the pathway. Clinical outcomes, length of hospitalization, and cost analyses were performed.


RESULTS
Adjusting for two outliers, the average length of stay for pathway patients was 7.3 days vs 12 days for prepathway patients. A total estimated cost-savings of $204,000 was ultimately achieved.


CONCLUSIONS
Our laryngectomy critical pathway has resulted in improved patient care and optimized allocation of medical resources.
Levin
R J
RJ
Department of Surgery, Section of Otolaryngology/Head & Neck Surgery, Penn State Geisinger Health System, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA. rlevin9999@aol.com
Ferraro
R E
RE
Kodosky
S R
SR
Fedok
F G
FG
D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D019091:Critical Pathways / Q000592:standards; D005260:Female; D006801:Humans; D007825:Laryngectomy / Q000191:economics* / Q000592:standards*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D005791:Patient Care / Q000191:economics / Q000706:statistics & numerical data; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome