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Benchmarking and clinical pathway implementation on a multihospital basis
1Hospital Executive Council, Syracuse, NY, USA.
Nursing Economic$
|May 1, 1997
Summary
Hospitals can use managed care data to set benchmarks for prospective pricing systems (PPS). Implementing clinical paths significantly reduced hospital length of stay (LOS) for total hip replacements by 28% and for stroke and acute MI by 17%.
Area of Science:
- Health Services Research
- Hospital Administration
- Healthcare Management
Background:
- High managed care penetration provides valuable data for establishing hospital utilization benchmarks.
- Prospective Pricing System (PPS) initiatives necessitate proactive preparation and benchmark development.
- Inter-hospital collaboration can leverage shared data for broader insights.
Purpose of the Study:
- To assess the effectiveness of clinical paths in reducing hospital length of stay (LOS).
- To develop utilization benchmarks using data from high managed care penetration areas.
- To evaluate the impact of standardized clinical pathways on resource utilization and patient outcomes.
Main Methods:
- Compared hospital LOS data from four Syracuse, NY hospitals with benchmarks from managed care-penetrated West Coast communities.
- Implemented clinical paths across all participating hospitals.
- Analyzed changes in mean LOS for specific DRGs (one surgical, three medical) after pathway implementation.
Main Results:
- A 28% reduction in mean LOS for total hip replacement procedures was observed.
- Mean LOS decreased by 17% for stroke (a medical DRG).
- Mean LOS decreased by 17% for acute myocardial infarction (MI) (a medical DRG).
Conclusions:
- Clinical path implementation is an effective strategy for reducing hospital LOS.
- Utilizing managed care data can inform the development of relevant utilization benchmarks.
- Standardized care pathways improve resource management and can lead to significant cost savings.