title: Effectiveness of critical care pathways for head and neck cancer surgery: A systematic review.
abstract: Critical care pathways (CCPs) are implemented within health care systems as a means to systematically decrease resource utilization, whereas maintaining a high level of care for patients with a specific diagnosis. Previous studies have shown equivocal results for CCPs in head and neck cancer surgery.
  
  
  
  We conducted a systematic review evaluating studies of CCPs for head and neck cancer surgery, with individual outcome measures analyzed separately to describe the effect of each implemented pathway.
  
  
  
  Ten before and after studies were included for systematic review. Nine reported statistically significant decreases in median/mean length of stay and 5 reported statistically significant decreases in cost of care per case.
  
  
  
  Although the results are encouraging and point toward the ability of CCPs to decrease length of stay and cost of care, the evidence cannot be considered exhaustive because of the studies' inability to account for temporal trends. Further controlled studies are recommended to validate the benefits of CCPs. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1421-1427, 2016.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Gordon
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
authors.forename: Evan R
authors.initials: ER
authors.lastname: Reiter
mesh_terms: D000046:Academic Medical Centers; D017046:Cost Savings; D003422:Critical Care / Q000458:organization & administration; D019091:Critical Pathways / Q000191:economics* / Q000458:organization & administration; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017048:Health Care Costs; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D058996:Quality Improvement; D016896:Treatment Outcome; D014481:United States
keywords: care pathway; clinical pathway; head and neck cancer; outcomes; surgery