Development and implementation of a clinical pathway for severe traumatic brain injury.
BACKGROUND
Clinical pathways (CPs) have been shown to be beneficial in optimizing patient care and resource use.


METHODS
A multidisciplinary CP for the treatment of severe traumatic brain injury (Glasgow Coma Scale score of 3-7) was developed. Data from these patients (group I) were collected prospectively and compared with a retrospective database (group II).


RESULTS
There were a total of 119 patients managed in conjunction with the CP and 43 patients in the control group. No statistical differences were found between the groups in age, Glasgow Coma Scale score at 24 hours, or Injury Severity Scores. There was a significant decrease in the length of hospital stay, intensive care unit stay, and length of ventilator support in the study group (group I: 22.5, 16.8, and 11.5 days, respectively; group II: 31.0, 21.2, and 14.4 days, respectively; p < 0.03).


CONCLUSIONS
The use of this CP helped to standardize and improve patient care with fewer complications and a potential cost savings of approximately $14,000 per patient.
Vitaz
T W
TW
Department of Neurological Surgery, University of Louisville School of Medicine, Kentucky, USA. tvitaz@niky.com
McIlvoy
L
L
Raque
G H
GH
Spain
D
D
Shields
C B
CB
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D003362:Cost-Benefit Analysis; D019091:Critical Pathways / Q000191:economics*; D005260:Female; D015600:Glasgow Coma Scale; D006284:Health Plan Implementation; D006785:Hospitals, University / Q000191:economics; D006801:Humans; D015601:Injury Severity Score; D007629:Kentucky; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000191:economics; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000191:economics; D012189:Retrospective Studies