Clinical pathways in general surgery. Development, implementation, and evaluation.
OBJECTIVE
To emphasize the importance of the view of business process management for development and implementation of clinical pathways, and to evaluate their effectiveness in reducing cost and effort as well as enhancing patient satisfaction.


METHODS
We describe the development and implementation of pathways with methods of process management and the design and realization of an evaluation study in the setting of a surgical department. For this study 67 patients treated without clinical pathways were compared with 62 patients treated using pathways.


RESULTS
The approach explicitly enhances the development and implementation of clinical pathways. The introduction of pathways reduces length of hospital stay, number of laboratory tests, number of consultations, and number of imaging procedures. Patient satisfaction is improved.


CONCLUSIONS
Depending on design and setting, the introduction of clinical pathways may be a very promising method to improve the inpatient service at a hospital and so to react to the challenges of increasing competition in medical care.
Graeber
S
S
Institute of Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Building 86, Saarland University Hospital, 66421 Homburg/Saar, Germany. graeber@med-imbei.uni-saarland.de
Richter
S
S
Folz
J
J
Pham
P-T
PT
Jacob
P
P
Schilling
M K
MK
D019411:Clinical Laboratory Techniques; D003163:Competitive Behavior; D019091:Critical Pathways; D020000:Decision Support Systems, Clinical; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D017060:Patient Satisfaction; D012017:Referral and Consultation; D011795:Surveys and Questionnaires