[Usefulness of an all-in-one clinical pathway for transurethral resection of prostate]

We evaluated the usefulness of our original all-in-one clinical pathway for transurethral resection of the prostate (TUR-P) on 86 consecutive patients. There were 27 consecutive patients treated before introduction of the clinical pathway (group 1). Twenty-nine consecutive patients were treated just after the introduction of the clinical pathway (group 2) and 30 consecutive patients were treated one year after the introduction of the clinical pathway (group 3). Our pathway includes all items such as vital sign charts and events charts. Although the hospitalization ranged from 5 days to 12 days after introduction of the clinical pathway, the average length of hospital stay was shortened by 2.6 days in group 3. Although the duration of the postoperative indwelling urethral catheter ranged from 2 days to 7 days in the groups 2 and 3, the average duration was approximately 4 days in group 3. Postoperative complications did not differ among the three groups. The medical insurance claims decreased with the introduction of the clinical pathway. Our all-in-one clinical pathway is considered to be a good tool for not only reduction of health care costs but also giving higher quality and better service to patients.