title: Carotid endarterectomy: creating the pathway to 1-day stay.
abstract: Use of a collaborative team approach to design a care pathway and standing orders for carotid endarterectomy patients achieved the project's goals. Variation, LOS, and resource consumption were decreased while quality of care and patients' satisfaction levels were maintained. Education of patients, patients' families, and staff members increased. Coordination between caregivers increased. The consistent concurrent database provided a feedback loop for continued change and for setting the target. Essential to the success was sponsorship from key leadership via the hospital's steering committee. The diverse membership of key associates on the CQI team helped to create an excellent revised carotid endarterectomy process and ensured full implementation. This membership of the CQI team was essential to comprehensive education and implementation. The step-by-step implementation kept the project moving forward. Creating a care pathway and changing practice require collaboration between nurses, doctors, and administrators. Creativity and systematic, thorough steps are what move a practice change from idea to inception.
authors.affiliation: Lutheran General Hospital, Advocate Health System, Park Ridge, IL, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Kallenbach
authors.forename: C J
authors.initials: CJ
authors.lastname: Rosenblum
mesh_terms: D003299:Cooperative Behavior; D003422:Critical Care / Q000458:organization & administration*; D019091:Critical Pathways / Q000458:organization & administration*; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000191:economics / Q000451:nursing / Q000592:standards*; D006769:Hospitals, General; D006801:Humans; D007087:Illinois; D007400:Interprofessional Relations; D007902:Length of Stay / Q000706:statistics & numerical data*; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000379:methods; D019990:Perioperative Care / Q000451:nursing / Q000458:organization & administration*; D015397:Program Evaluation; D011383:Progressive Patient Care / Q000458:organization & administration*; D017749:Total Quality Management / Q000458:organization & administration*