Physician-directed therapeutic plan for large and small bowel procedures: a quality improvement project at St....

Project Overview: St. Vincent's Health System sought to increase the efficiency of and decrease costs for care of patients undergoing large or small bowel procedures (DRGs 148 and 149), while maintaining or improving patient outcomes. A multidisciplinary, physician-led task force developed a physician-directed therapeutic plan that was implemented in January 1992.

In 1992, the average cost per case for 188 patients in DRG 148 was $12,507, a 5.4 percent reduction from the 1991 cost (a 12.9 percent reduction when inflation is taken into account). Length of stay was reduced by nearly one day, from 15.48 days to 14.56 days.