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Decreased resource utilization since initiation of institutional clinical pathway for care of children with

E Marty Knott1, Alessandra C Gasior, Daniel J Ostlie

  • 1Children's Mercy Hospital and Clinics, Kansas City, MO 64108, USA.

Journal of Pediatric Surgery
|July 13, 2013
PubMed

Insights

A new clinical pathway for perforated appendicitis significantly reduced hospital resource use. This evidence-based approach shortened patient length of stay and decreased the need for nasogastric tubes and central lines.

Area of Science:

  • Pediatric Surgery
  • Clinical Pathway Development
  • Healthcare Resource Management

Background:

  • Perforated appendicitis requires significant healthcare resources.
  • Clinical pathways aim to standardize care and improve outcomes.
  • Evidence-based practices are crucial for optimizing patient management.

Purpose of the Study:

  • To evaluate the impact of an evidence-based clinical pathway on resource utilization in children with perforated appendicitis.
  • To assess changes in patient management strategies and clinical outcomes after pathway implementation.

Main Methods:

  • Retrospective review of patients undergoing appendectomy for perforated appendicitis.
  • Comparison of patient data from before (July 2001-December 2003) and after (December 2008-March 2011) pathway implementation.
  • Evaluation of demographics, management strategies, and resource utilization metrics.

Main Results:

  • Reduced use of nasogastric tubes (NGTs) upon operating room departure.
  • Decreased rates of peripherally inserted central catheters (PICC lines) and total parenteral nutrition (TPN).
  • Significant reductions in daily intravenous antibiotics, laboratory draws, and length of hospital stay (by over one day).

Conclusions:

  • The implemented evidence-based clinical pathway significantly reduced resource utilization for pediatric perforated appendicitis.
  • Standardized care protocols can lead to more efficient and effective patient management.
  • This pathway demonstrates a successful model for optimizing care in pediatric surgical emergencies.
Abstract

Keywords:
ChildrenClinical pathwayPerforated appendicitisProtocolResource utilization

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