title: The Halo Effect: An Unintended Benefit of Care Pathways.
abstract: The objective of this study was to determine if implementation of a simplified care pathway for total knee arthroplasty (TKA) would affect outcomes of total hip arthroplasty (THA) patients in the same health care system. Data were collected from a total of 5,095 consecutive THA patients in the year before and 2 years after implementation of the care pathway for TKA patients. Postimplementation increases were observed in both early activity (p< 0.0001) and continuous urinary catheter avoidance (p< 0.0001) among THA patients. These improvements in protocol adherence were associated with decreased complications (p< 0.0001), fewer 30-day readmissions (p< 0.0019), and decreased hospital length of stay (p< 0.0001). Based on these results, the implementation of a simplified care pathway for TKA patients can also improve outcomes for THA patients in the same health care system.
authors.affiliation: Banner Health, University Medical Center, Phoenix, Arizona.
authors.forename: Collin
authors.initials: C
authors.lastname: Barber
authors.affiliation: Banner Health, University Medical Center, Phoenix, Arizona.
authors.forename: James F
authors.initials: JF
authors.lastname: Fraser
authors.affiliation: Clinical Performance Analytics, Banner Health System Ringgold Standard Institution, Phoenix, Arizona.
authors.forename: Guillermo G
authors.initials: GG
authors.lastname: Mendez
authors.affiliation: Division of Care Management, Banner Health, Phoenix, Arizona.
authors.forename: Barrie
authors.initials: B
authors.lastname: Bradley
authors.affiliation: Department of Research, Loftus Health, Tempe, Arizona.
authors.forename: Terry J
authors.initials: TJ
authors.lastname: Loftus
authors.affiliation: Department of Research, The CORE Institute, Phoenix, Arizona.
authors.forename: David J
authors.initials: DJ
authors.lastname: Jacofsky
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D002985:Clinical Protocols; D019091:Critical Pathways; D004434:Early Ambulation; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014546:Urinary Catheterization