THE EFFECT OF CLINICAL PATHWAY COMPLIANCE IN REDUCING LENGTH OF STAY

Michael Siswanto, Djazuly Chalidyanto

= http://dx.doi.org/10.20473/jaki.v8i1.2020.79-90
Abstract views = 665 times | downloads = 425 times

Abstract


Background: Clinical pathway is multidisciplinary care plan based on the best clinical practice for a group of patients with a particular diagnosis, designed to minimize care delay as well as maximize the quality of care and clinical outcomes. In 2017, average length of stay for pediatric patient with acute gastroenteritis was prolonged even clinical pathways had been implemented.

Aim: Thid study determined the diagnostic examination and therapy compliance of clinical pathway related to the length of stay.

Method: This study was cross sectional research through simple random sampling. Researchers analyzed pediatric patients whose clinical pathway were filled completely by doctors. The inclusion criteria were pediatric patients, admitted to hospitals during January to December 2018 as acute gastroenteritis patients. The data were analyzed using multiple classification analysis.

Results: There were 197 patients with clinical pathway filled completely. As much as 60.91% of cases were compiled for diagnostic examination and 88.32% for therapy. There was no statistically significant correlation between diagnostic examination compliance (p > 0.05) and therapy compliance (p > 0.05) of clinical pathway with patients’ length of stay (combined = p > 0.05).

Conclusion: Many factors could be related with the length of stay especially patients’ condition itself. In this study, clinical pathway compliance has no impact in reducing length of stay.

 

Keywordsclinical pathway, compliance, length of stay, pediatric.

 


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References


Ahmed, A. et al. (2017) 'Association of Guideline Adherence for Serial Evaluations With Survival and Adverse Clinical Events in Patients With Asymptomatic Severe Aortic Stenosis', JAMA Cardiology, 2(10), pp. 1141-1146.

Aniza, I. et al. (2016) 'Implementation of clinical pathways in Malaysia : Can clinical pathways improve the quality of care ? Implementation of Clinical Pathways in Malaysia : Can Clinical Pathways Improve the Quality of Care?', International Medical Journal, 23(1), pp. 47-50.

Asmirajanti, M. et al. (2018) 'Clinical care pathway strenghens interprofessional collaboration and quality of health service: a literature review', Enfermería Clínica, 28(Supplement 1), pp. 240–244.

Aspland, E. et al. (2019) 'Clinical pathway modelling : a literature review Clinical pathway modelling : a literature review', Health Systems, pp. 1–23. doi: https://doi.org/10.1080/20476965.2019.1652547.

Baek, H. et al. (2018) 'Analysis of length of hospital stay using electronic health records : A statistical and data mining approach', PloS one, 13(4), pp. 1–16.

Bai, J. et al. (2018) 'The perceived and objectively measured effects of clinical pathways’ implementation on medical care in China', PloS one, 13(5), pp. 1–13.

Bryan, M. A., Desai, A. D. and Wilson, L. (2019) 'Association of Bronchiolitis Clinical Pathway Adherence With Length of Stay and Costs', Pediatrics, 139(3), pp. 1-8.

Buchert, A. R. and Butler, G. A. (2016) 'Clinical pathways: driving high-reliability and high-value care', Pediatric Clinics, 63(2), pp. 317–328. doi: http://dx.doi.org/10.1016/j.pcl.2015.12.005.

Carson, R. A., et al. (2017) 'Evaluation of a nurse-initiated acute gastroenteritis pathway in the pediatric emergency department', Journal of Emergency Nursing, 43(5), pp. 406-412.

Cudre, L. et al. (2016) 'Implementation of a visceral surgery clinical pathway : Evaluating patient satisfaction with information , safety and involvement in care', International Journal of Care Coordination, 18(4), pp. 93–99.

Ellen, M., Baker, G. R. and Brown, A. (2017) 'The impact of acute care clinical practice guidelines on length of stay : A closer look at some conflicting findings', Journal of Hospital Administration, 3(4), pp. 25-36.

Elliott, C. and Justiz-vaillant, A. (2018) 'Nosocomial Infections: A 360-degree Review', International Biological and Biomedical Journal, 4(2), pp. 72-81.

Fujino, Y. et al. (2014) ‘Impact of Regional Clinical Pathways on the Length of Stay in Hospital Among Stroke Patients in Japan’, Medical care, 52(7), pp. 634–640.

Guarino, A. et al. (2014) 'European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014', Journal of pediatric gastroenterology and nutrition, 59(1), pp. 132-152.

Haninditya, B. et al. (2019) 'Analisis Kepatuhan Pelaksanaan Clinical Pathway Sesarea di Sebuah Rumah Sakit Swasta di Yogyakarta Seksio', Jurnal Manajemen Dan Pelayanan Farmasi, 9(1), pp. 38–45.

Haque, M. et al. (2018) 'Health care-associated infections – an overview', Infection and drug resistance, 11, pp. 2321–2333.

Hulley, S. B. et al. (2013) Designing Clinical Research. 4th edn. Philadelphia: Lippincott William & Wilkins.

Kaiser, S. V. et al. (2018) 'Effectiveness of Pediatric Asthma Pathways for Hospitalized Children', The Journal of Pediatrics, 197, pp. 165-171. doi: https://doi.org/10.1016/j.jpeds.2018.01.084.

Kolk, M. van der et al. (2017) 'Implementation and Evaluation of a Clinical Pathway for Pancreaticoduodenectomy Procedures : a Prospective Cohort Study', Journal of Gastrointestinal Surgery, 21, pp. 1428–1441.

Komajda, M. et al. (2017) 'Physicians’ guideline adherence is associated with better prognosis in outpatients with heart failure with reduced ejection fraction : the QUALIFY international registry', European journal of heart failure, 19, pp. 1414–1423.

Li, W. et al. (2014) 'Integrated clinical pathway management for medical quality improvement – based on a semiotically inspired systems architecture', European Journal of Information Systems, 23, pp. 400–417.

Lifland, B. et al. (2018) 'The Impact of an Adolescent Depressive Disorders Clinical Pathway on Healthcare Utilization', Administration and Policy in Mental Health and Mental Health Services Research, 45(6), pp. 979-987. doi: http://dx.doi.org/10.1007/s10488-018-0878-6.

Mammen, C., Matsell, D. G. and Lemley, K. V (2013) 'The importance of clinical pathways and protocols in pediatric nephrology', Pediatric Nephrology, 29(10), pp. 1903-1914.

Marincowitz, C. et al. (2019) 'Evaluation of the impact of the NICE head injury guidelines on inpatient mortality from traumatic brain injury : an interrupted time series analysis', BMJ open, 9(e028912), pp. 1-9.

Mater, W. and Ibrahim, R. (2014) 'Delivering Quality Healthcare Services using Clinical Pathways', International Journal of Computer Applications, 95(1), pp. 5–8.

Opoka, R. O. et al. (2019) 'Adherence to clinical guidelines is associated with reduced inpatient mortality among children with severe anemia in Ugandan hospitals', PloS one, 14(1), pp. 1–15.

Schmier, J. K. et al. (2016) 'Estimated hospital costs associated with preventable health care-associated infections if health care antiseptic products were unavailable', Clinico Economics and Outcomes Research, 8, pp. 197–205.

Wathne, J. S. et al. (2019) 'The association between adherence to national antibiotic guidelines and mortality , readmission and length of stay in hospital inpatients : results from a Norwegian multicentre , observational cohort study', Antimicrobial Resistance & Infection Control, 8(63), pp. 1–10.

Wetherill, C. V. et al. (2016) 'Implementation of a care pathway for infantile hypertrophic pyloric stenosis reduces length of stay and increases parent satisfaction', International Journal of Care Coordination, 18(4), pp. 78–84.

Zhang, M. et al. (2014) 'The application of clinical pathways in laparoscopic cholecystectomy', Hepatobiliary & Pancreatic Diseases International, 13(4), pp. 348–353. doi: http://dx.doi.org/10.1016/S1499-3872(14)60279-4.


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