title: Assessing a clinical pathway to improve the quality of care in pulmonary resections.
abstract: OBJECTIVE
  To evaluate the efficacy of the current clinical pathway for pulmonary resections.
  
  
  METHODS
  This study examined variances from expected clinical pathway outcomes for pulmonary resections performed between 2005 and 2009. Data on a total of 383 patients were retrospectively analyzed.
  
  
  RESULTS
  The median length of hospital stay (LOS) using the clinical pathway was 12 days (range: 1-188 days); the mean LOS was 15.5 days. The cost per day with use of the clinical pathway was 102 726 yen. Poor control of pain from intercostal neuralgia was the most frequently observed variance from expected outcomes. It affected 119 of 168 electronic clinical pathway patients (70.8%). The clinical pathway was terminated in 3.9% of patients (15/383) due to serious or life-threatening complications.
  
  
  CONCLUSIONS
  This study showed the single institutional experience of the clinical pathway for pulmonary resections. These findings indicate a need to revise certain aspects of the pathway, based on data from our analysis of variances.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Shoji
authors.forename: Tokujiro
authors.initials: T
authors.lastname: Yano
authors.forename: Akira
authors.initials: A
authors.lastname: Haro
authors.forename: Tsukihisa
authors.initials: T
authors.lastname: Yoshida
authors.forename: Kensaku
authors.initials: K
authors.lastname: Ito
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Morodomi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Wakata
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002648:Child; D019091:Critical Pathways / Q000592:standards*; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D008171:Lung Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000191:economics / Q000592:standards*; D011787:Quality of Health Care; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult