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Liu J, Zhang G, Xie X, Fu X, Gao F, Zheng G, Han J, Wang Y, Zhang J, Zhang X. Effect of comprehensive nursing on quality of life of patients with cholecystolithiasis after laparoscopic surgery. Minerva Surg 2021; 77:84-86. [PMID: 34342397 DOI: 10.23736/s2724-5691.21.08945-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jiao Liu
- Department of Biliary and Pancreatic Surgery, Shanxi Bethune Hospital, Taiyuan, China
| | - Guohong Zhang
- Department of Biliary and Pancreatic Surgery, Shanxi Bethune Hospital, Taiyuan, China
| | - Xianping Xie
- Department of Nursing, Shanxi Bethune Hospital, Taiyuan, China
| | - Xifeng Fu
- Department of Biliary and Pancreatic Surgery, Shanxi Bethune Hospital, Taiyuan, China
| | - Fei Gao
- Department of Biliary and Pancreatic Surgery, Shanxi Bethune Hospital, Taiyuan, China
| | - Gang Zheng
- Department of Biliary and Pancreatic Surgery, Shanxi Bethune Hospital, Taiyuan, China
| | - Junfeng Han
- Department of Biliary and Pancreatic Surgery, Shanxi Bethune Hospital, Taiyuan, China
| | - Yongze Wang
- Department of Biliary and Pancreatic Surgery, Shanxi Bethune Hospital, Taiyuan, China
| | - Jing Zhang
- Department of Biliary and Pancreatic Surgery, Shanxi Bethune Hospital, Taiyuan, China
| | - Xiaohong Zhang
- Department of Nursing, Shanxi Bethune Hospital, Taiyuan, China -
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Lee XJ, Blythe R, Choudhury AAK, Simmons T, Graves N, Kularatna S. Review of methods and study designs of evaluations related to clinical pathways. AUST HEALTH REV 2020; 43:448-456. [PMID: 30089529 DOI: 10.1071/ah17276] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 05/19/2018] [Indexed: 11/23/2022]
Abstract
Objective The HealthPathways program is an online information portal that helps clinicians provide consistent and integrated patient care within a local health system through localised pathways for diagnosis, treatment and management of various health conditions. These pathways are consistent with the definition of clinical pathways. Evaluations of HealthPathways programs have thus far focused primarily on website utilisation and clinical users' experience and satisfaction, with limited evidence on changes to patient outcomes. This lack motivated a literature review of the effects of clinical pathways on patient and economic outcomes to inform a subsequent HealthPathways evaluation. Methods A systematic review was performed to summarise the analytical methods, study designs and results of studies evaluating clinical pathways with an economic outcome component published between 1 January 2000 and 31 August 2017 in four academic literature databases. Results Fifty-five relevant articles were identified for inclusion in this review. The practical pre-post study design with retrospective baseline data extraction and prospective intervention data collection was most commonly used in the evaluations identified. Straightforward statistical methods for comparing outcomes, such as the t-test or χ2 test, were frequently used. Only four of the 55 articles performed a cost-effectiveness analysis. Clinical pathways were generally associated with improved patient outcomes and positive economic outcomes in hospital settings. Conclusions Clinical pathways evaluations commonly use pragmatic study designs, straightforward statistical tests and cost-consequence analyses. More HealthPathways program evaluations focused on patient and economic outcomes, clinical pathway evaluations in a primary care setting and cost-effectiveness analyses of clinical pathways are needed. What is known about the topic? HealthPathways is a web-based program that originated from Canterbury, New Zealand, and has seen uptake elsewhere in New Zealand, Australia and the UK. The HealthPathways program aims to assist the provision of consistent and integrated health services through dedicated, localised pathways for various health conditions specific to the health region. Evaluations of HealthPathways program focused on patient and economic outcomes have been limited. What does this paper add? This review synthesises the academic literature of clinical pathways evaluations in order to inform a subsequent HealthPathways evaluation. The focus of the synthesis was on the analytical methods and study designs used in the previous evaluations. The previous clinical pathway evaluations have been pragmatic in nature with relatively straightforward study designs and analysis. What are the implications for practitioners? There is a need for more economic and patient outcome evaluations for HealthPathways programs. More sophisticated statistical analyses and economic evaluations could add value to these evaluations, where appropriate and taking into consideration the data limitations.
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Affiliation(s)
- Xing Ju Lee
- Institute of Health and Biomedical Innovations, School of Public Health and Social Work, Queensland University of Technology, Brisbane, 60 Musk Avenue, Kelvin Grove, Qld 4059, Australia.
| | - Robin Blythe
- Institute of Health and Biomedical Innovations, School of Public Health and Social Work, Queensland University of Technology, Brisbane, 60 Musk Avenue, Kelvin Grove, Qld 4059, Australia.
| | - Adnan Ali Khan Choudhury
- Northern Queensland Primary Health Network, James Cook University, Building 500, 1 James Cook Drive, Douglas, Qld 4811, Australia. Email
| | - Toni Simmons
- Mackay Hospital and Health Service, Mackay, 475 Bridge Road, Mackay, Qld 4740, Australia. Email
| | - Nicholas Graves
- Institute of Health and Biomedical Innovations, School of Public Health and Social Work, Queensland University of Technology, Brisbane, 60 Musk Avenue, Kelvin Grove, Qld 4059, Australia.
| | - Sanjeewa Kularatna
- Institute of Health and Biomedical Innovations, School of Public Health and Social Work, Queensland University of Technology, Brisbane, 60 Musk Avenue, Kelvin Grove, Qld 4059, Australia.
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Kwon H, Lee JH, Woo J, Lim W, Moon BI, Paik NS. Efficacy of a clinical pathway for patients with thyroid cancer. Head Neck 2018; 40:1909-1916. [PMID: 29637689 DOI: 10.1002/hed.25175] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 12/06/2017] [Accepted: 02/15/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Clinical pathways have been proposed as a way to improve organizational efficiency and maximize patient outcomes. However, little is known as to whether a clinical pathway is effective for thyroid cancer. METHODS The study subjects included 216 patients who were managed after clinical pathway implementation and 145 control patients. Length of stay, cost per patient, and nurses' satisfaction were compared in the 2 groups. RESULTS Mean length of stay was 0.8 days shorter in the clinical pathway group than in the control group (2.9 vs 3.7 days; P = .023). Cost per patient was also lower in the clinical pathway than in the control group (USD $3953.00 vs USD $4636.00; P < .001). Nurses' overall satisfaction scores improved from 71.6% before to 82.5% after implementation of the clinical pathway and their job characteristics scores increased from 61.1% to 75.0%. CONCLUSION Implementation of a clinical pathway for thyroid cancer can improve nurses' satisfaction with reduction of hospital stay and costs.
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Affiliation(s)
- Hyungju Kwon
- Breast and Thyroid Cancer Center, Ewha Womans University College of Medicine, Seoul, Korea.,Department of Surgery, Ewha Womans University College of Medicine, Seoul, Korea
| | - Joon-Hyop Lee
- Thyroid and Endocrine Surgery Section, Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Joohyun Woo
- Breast and Thyroid Cancer Center, Ewha Womans University College of Medicine, Seoul, Korea.,Department of Surgery, Ewha Womans University College of Medicine, Seoul, Korea
| | - Woosung Lim
- Breast and Thyroid Cancer Center, Ewha Womans University College of Medicine, Seoul, Korea.,Department of Surgery, Ewha Womans University College of Medicine, Seoul, Korea
| | - Byung-In Moon
- Breast and Thyroid Cancer Center, Ewha Womans University College of Medicine, Seoul, Korea.,Department of Surgery, Ewha Womans University College of Medicine, Seoul, Korea
| | - Nam Sun Paik
- Breast and Thyroid Cancer Center, Ewha Womans University College of Medicine, Seoul, Korea.,Department of Surgery, Ewha Womans University College of Medicine, Seoul, Korea
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