title: Pilot study of a clinical pathway implementation in rectal cancer.
abstract: BACKGROUND
  Rectal cancer is a highly prevalent disease which needs a multidisciplinary approach to be treated. The absence of specific protocols implies a significant and unjustifiable variability among the different professionals involved in this disease. The purpose is to develop a clinical pathway based on the analysis process and aims to reduce this variability and to reduce unnecessary costs.
  
  
  METHODS
  We created a multidisciplinary team with contributors from every clinical area involved in the diagnosis and treatment in this disease. We held periodic meetings to agree on a protocol based on the best available clinical practice guidelines. Once we had agreed on the protocol, we implemented its use as a standard in our institution. Every patient older than 18 years who was diagnosed with rectal cancer was considered a candidate to be treated via the pathway.
  
  
  RESULTS
  We evaluated 48 patients during the course of this study. Every parameter measured was improved after the implementation of the pathway, except the proportion of patients with 12 nodes or more analysed. The perception that our patients had about this project was very good.
  
  
  CONCLUSIONS
  Clinical pathways are needed to improve the quality of health care. This kind of project helps reduce hospital costs and optimizes the use of limited resources. On the other hand, unexplained variability is also reduced, with consequent benefits for the patients.
authors.affiliation: Oncology Department Clinical University Hospital of Valladolid, 47005 Valladolid, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Uña
authors.forename: Francisco
authors.initials: F
authors.lastname: López-Lara