A Study On Clinical Pathway Of Cholecystectomy

Objective: To formulate a science plan (form) on cholecystectomy clinical pathway (CP), implementat and assess it in the study, The effect CP mode in standarding the medical care programmes, improving the quality of medical care ,reducting the average hospitalized days and hospitalization costs ,improving the satisfaction of patients was estimated in this study.Methods: Based on retrospective survey 96 patients in a hospital between August 2005 and June 2006, we can formulate the form of cholecystectomy CP and compute the standard hospitalized days by statistical and expert consulation method. One hundred sixty-four cases who was treated by CP and 145 cases who was not treated by CP from July 2006 to december 2007 were studied by comparation analysis and the variance was also analyzed. Different statistic methods including rank testing,multiple linear regression, evidence-based medicine, expert consulation and continuous quality improvement were used in CP form formulation. The general descriptive statistics, T-test and rank testing methods were used to assess the effect of CP.Results: After clinical pathway implementation on Cholecystectomy,the study indicates that the index of the days in hospital, the days between admission and operation, the days between operation and discharge were respectively 9.97 days,2.46 days,7.28 days in the group of implementation and 12.85 days,2.81 days,9.98 days in the control group;The mean cost of the total expense be in hospital, the espense of drug, the espense of surgical operation ,the expense of examination, the expense of bed, the expense of medical image, the other epense were respectively 5029.64 yuan,1612.11 yuan,1698.25 yuan,408.42 yuan,123.38 yuan,658.65 yuan,316.41 yuan,397.54 yuan in the group of implementation and 6787.56 yuan,2318.98 yuan,1987.60 yuan,676.25 yuan,189.96 yuan,1196.85 yuan,389.54 yuan,788.93 yuan in the control group,there were the significant statistical difference in the index of the days in hospital, the days between operation and discharge, the total expense be in hospital, the espense of drug, the expense of bed, the expense of medical image, the other epense(P<0.05);In the assess of treat,the implemented group(90.24 %) highly satisfied with the control group(80.69 %) in the improvement of patiens;In the assess of medical satisfaction,the scores of office staff satisfaction,the doctor satisfaction,the nurse satisfaction,the others department satisfaction,the whole satisfaction were respectively 89.65,87.51,90.56,81.73,87.38 in the implemented group and 78.46,74.58,79.95,80.84,78.36 in the control group,there were the significant statistical difference in the index of office staff satisfaction,the doctor satisfaction,the nurse satisfaction,the whole satisfaction (P<0.05). Conclusion: Present study show that the implementation of CP standardize clinic treating and nursing behavio effectively reduce the single disease average days of stay in hospital and the average cost of hospitalization, increased the patients satisfaction. The CP can bring the more economic and social benefits for the hospital.