Web-based clinical pathway for reducing practice variations in radical prostatectomy

Chang Gung Med J. 2008 Nov-Dec;31(6):567-75.

Abstract

Background: A clinical pathway support system on the Internet (CPSSI) has been designed for creating and implementing a web-based clinical pathway for radical prostatectomy. This investigation assessed the effects of the web-based clinical pathway for radical prostatectomy on practice variations.

Methods: From June 2002 to Jun 2003, 22 consecutive patients with localized prostate cancer who underwent radical prostatectomy were treated according to the web-based clinical pathway. The treatment results were compared with an identically sized sample of patients treated during the year before implementing the web-based clinical pathway. Variations before and following the implementation of the web-based clinical pathway for radical prostatectomy were also assessed. The CPSSI automatically measured pathway variations and length of hospital stay.

Results: After implementing the web-based clinical pathway, the average hospital stay was reduced significantly (p=0.0001). The mean number of variations also differed markedly (p=0.0002).

Conclusion: This study concludes that the CPSSI-based clinical pathway support system may provide a good tool for creating and implementing a web-based clinical pathway. After implementing the web-based clinical pathway for radical prostatectomy, practice variations and length of stay were reduced considerably. Moreover, automatically assessing the effects of web-based clinical pathway implementation can enhance the quality of patient care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Critical Pathways*
  • Humans
  • Internet*
  • Male
  • Middle Aged
  • Prostatectomy*
  • Prostatic Neoplasms / surgery*