Clinical pathway for hip arthroplasty six years after introduction.
OBJECTIVE
This paper seeks to analyse clinical pathways (CP) as a useful tool for the improvement of all aspects of quality in medical assistance - in this case, hip arthroplasty.


METHODS
The study was carried out on patients who had undergone scheduled hip arthroplasty included in CP during the years 1999 to 2004. Data on demographics, lengths of stay, complications, process and result variables were gathered, coverage was calculated and the evolution of the indicators was compared.


RESULTS
A total of 487 patients were enrolled, with five leaving the pathway and with unequal coverage, leading to a maximum peak of 77 per cent in 1999. A statistically significant decrease exists in the consumption of overall stays and in the pre-surgical stay, which dropped from a mean of 19.41 days in the pre-pathway situation to 10.12 days in 2004 and 4.5 days pre-surgery to 1.08 days. As a process indicator, the performance should be highlighted of post-operation check-up radiographies, which have been gaining high levels of compliance (p < 0.05) since 2001. The rate of complications has remained stable over the years.


CONCLUSIONS
Implementing the CP has meant a sustained saving of resources over the years and an improvement in the organization of work.
Jimenez Muñoz
A B
AB
Preventive Medicine and Quality Management Service, Gregorio Marañón University General Hospital, Madrid, Spain. abjimenez.hgugm@salud.madrid.org
Duran Garcia
M E
ME
Rodriguez Perez
M P
MP
Sanjurjo
M
M
Vigil
M D
MD
Vaquero
J
J
D019644:Arthroplasty, Replacement, Hip; D019091:Critical Pathways / Q000592:standards*; D005500:Follow-Up Studies; D006801:Humans; D011446:Prospective Studies; D011787:Quality of Health Care; D013030:Spain