[Reduction in hospital stay after the implementation of a clinical pathway for patients with pacemaker implantation]

Clinical pathways (CPs) are structured care plans designed to improve the quality of healthcare. In July 2020, we initiated a CP for patients admitted from the Emergency Department with a pacemaker indication.

This study was conducted in a tertiary care hospital. It followed a pre-post design to evaluate outcomes after the implementation of the CP. Under this model, patients without contraindications for early intervention were included in the CP and managed by the Arrhythmia Unit, while the rest were treated according to standard care practices. Data from 2019, prior to the introduction of the CP, served as a baseline and were compared with data from 2022, when the CP was fully integrated.

Between 2019 and 2022, 851 patients with pacemaker indications were admitted from the Emergency Department. The mean age was 78.35±9.5 years, and 380 were women. There was a significant reduction in hospital stay, from 6.52±2.21 days in 2019 to 5.01±2.77 days in 2022 (p<0.01). No differences were detected in mortality rate or 30-day readmissions before and after program initiation. Patients who could not be included in the CP did not experience an unjustified delay in time to intervention.

The implementation of a CP for patients admitted from the Emergency Department with pacemaker indications was associated with a significant reduction in hospital stay duration, without observing differences in clinical outcomes compared to patients not included in the CP.