title: Impact of clinical pathway on quality of care in sickle cell patients.
abstract: Clinical pathways are disease specific and are designed to standardize care. They are intended to serve the purpose of improving quality of care and decreasing healthcare and societal costs. A retrospective cross-sectional study was conducted comparing sickle cell patients admitted to Mercy Children's Hospital (MCH) from June 1999 to November 2001 before the implementation of the clinical care pathway (n=66), to a similar group of patients admitted from December 2001 to July 2004 after pathway (n=121) implementation. The χ2 tests were used to compare categoric variables and independent t-tests for continuous variables. The results indicate improvement in compliance postpathway with specific care elements: incentive spirometry, pulse oximetry, ordering comfort measures, right dosage of pain medications, and achieving excellent nursing compliance in documenting pain scores. There was a significant decrease in the number of blood transfusions in postpathway patients. Though limited by sample size, the results suggest that clinical pathways are good tools for standardization of care in certain care elements and help to improve quality of care in sickle cell patients.
authors.affiliation: Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Archana
authors.initials: A
authors.lastname: Jayaram
authors.forename: Rollin W
authors.initials: RW
authors.lastname: Nagel
authors.forename: Rama
authors.initials: R
authors.lastname: Jasty
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000451:nursing* / Q000628:therapy*; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D019091:Critical Pathways / Q000458:organization & administration* / Q000592:standards*; D003430:Cross-Sectional Studies; D006776:Hospitals, Pediatric / Q000592:standards; D006801:Humans; D010092:Oximetry; D010146:Pain / Q000188:drug therapy; D011787:Quality of Health Care; D012189:Retrospective Studies; D013147:Spirometry