Clinical evaluation of a critical path for coronary artery bypass surgery patients

The critical path, one component of the case management model, was examined to determine its accuracy in describing patient recovery following coronary artery bypass surgery and to determine if variations from the path influenced postoperative length of stay. One hundred ninety-five (195) postoperative days were analyzed on 28 subjects. Data about patient characteristics, daily progress, and recovery following transfer from intensive care until hospital discharge were compared to expected patient progress and recovery as delineated by the critical path. Fifty-seven percent (57%) of the patients (n = 28) were discharged within the time frames designated by the critical path. Significant correlations (p less than or equal to .01) were found between postoperative length of stay and the variables of activity progression (r = -.46), telemetry usage (r = -.56), inspirometer use (r = -.35), and adherence to the critical path (r = -.48). Using step-wise multiple regression analysis, overall adherence to the critical path in the areas of telemetry usage and activity progression were found to be significant predictors of postoperative length of stay (combined R2 = .65).