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Fast track pathway provides safe, value based care on busy acute care surgery service
Kali Kuhlenschmidt1, Natasha Houshmand, Erika Bisgaard
1From the Division of General and Acute Care Surgery, Department of Surgery, UT Southwestern Medical Center, Dallas, Texas.
The Journal of Trauma and Acute Care Surgery
|December 11, 2020
Summary
Implementing a Fast Track (FT) pathway for acute cholecystitis significantly reduced hospital length of stay and improved resource utilization. This approach enhanced patient care without compromising clinical outcomes.
Area of Science:
- Surgical Pathway Optimization
- Acute Care Surgery Innovations
- Healthcare Resource Management
Background:
- Fast Track (FT) pathways are common in elective surgery but underutilized in acute care settings.
- This study investigated the efficacy of an FT pathway for acute cholecystitis.
- The hypothesis was that an FT pathway would decrease length of stay and resource utilization.
Purpose of the Study:
- To evaluate the impact of a Fast Track pathway on acute cholecystitis patient outcomes.
- To assess changes in length of stay and resource utilization.
- To determine if clinical outcomes are compromised by the FT pathway.
Main Methods:
- Retrospective chart review of patients undergoing urgent laparoscopic cholecystectomy for acute cholecystitis.
- Comparison between patients managed under an FT pathway and a traditional pathway.
- Data collected included demographics, operative details, hospital course, and outcomes such as time to OR and length of stay.
Main Results:
- The FT pathway was used in 89.8% of 479 urgent laparoscopic cholecystectomies.
- FT pathway patients had a significantly shorter median length of stay (22.6 vs. 38.5 hours, p < 0.001).
- More FT patients were discharged from the postanesthesia care unit (75.6% vs. 12.2%, p < 0.001), with similar readmission and complication rates.
Conclusions:
- The Fast Track pathway for acute cholecystitis positively impacts resource utilization.
- Implementation of FT pathways can lead to shorter hospital stays without negatively affecting patient outcomes.
- FT pathways represent an effective strategy for managing acute cholecystitis in surgical care.
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