[Application of a clinical pathway for the treatment of transient ischaemic attacks: implementation strategies and appraisal at two years].
BACKGROUND
Management of cerebral vascular pathologies by means of clinical pathways allows us to make cost effective use of resources, to enhance health care quality and to obtain a greater degree of satisfaction in patients.


OBJECTIVE
To assess the efficiency of applying a clinical pathway designed for the treatment of transient ischemic attacks (TIA) by monitoring a series of indicators that enable us to detect existing problems, to introduce any corrections that are needed and to draw conclusions that can be useful in the future.


METHODS
To this end, a clinical pathway was drawn up with the general agreement of the members of our service and the different professionals involved in caring for these patients. Analyses were performed to study the data from 1998 to 2001, prior to implementation of the pathway, and from 2002 and 2003, which were the first years in which it was being applied. Altogether 1,433 patients with a diagnosis of TIA were hospitalised during this period, 554 of whom were admitted during the years 2002 and 2003.


RESULTS
Of this group, the pathway was initially applied in 123 cases and 62 completed it. The mean stay in hospital was reduced from 9.2 days in 2000 to 5.7 days in 2003. The mean stay of patients who fulfilled all the requirements of the pathway was only 2.9 days. As far as the survey on satisfaction is concerned, 97% of patients said they were satisfied or very satisfied with the care they had received.


CONCLUSIONS
The application of a clinical pathway in the treatment of TIA resulted in a high degree of satisfaction among the patients who were treated and a notable reduction in the mean stay in hospital.
López-Gastón
J I
JI
Servicio de Neurología, Hospital Universitario Miguel Servet, 50009 Zaragoza, España.
Sánchez-Marín
B
B
Marta
J
J
Alarcia-Alejos
R
R
Oliván-Usieto
J A
JA
Artal-Roy
J
J
García-Gomara
M J
MJ
D000465:Algorithms; D003365:Costs and Cost Analysis; D019091:Critical Pathways; D017048:Health Care Costs; D006785:Hospitals, University; D006801:Humans; D002546:Ischemic Attack, Transient / Q000628:therapy*; D007902:Length of Stay; D017060:Patient Satisfaction; D011787:Quality of Health Care; D012189:Retrospective Studies; D011795:Surveys and Questionnaires