Gallstones
Conditions
Keywords
cholecystectomy, check list
Brief summary
Compliance to the clinical pathway, postoperative complication and total cost of the hospitalisation of patients undergoing elective cholecystectomy for symptomatic cholecystolithiasis were collected over two different periods: using a clinical pathway in form of a paper based check-list (group 1, n=118) or a clinical pathway integrated into the paper based medical treatment and nursing documentation (group 2, n=123). Outcome measures were compliance of the clinical pathway and total costs per case.
Detailed description
Data of patients undergoing elective cholecystectomy for symptomatic cholecystolithiasis were collected over two different periods: a clinical pathway in form of a paper based check-list (check-list group, n=118, or in form of a clinical pathway integrated into the paper based medical treatment and nursing documentation (integrated clinical pathway group, n=123. A standardized clinical pathway for elective laparoscopic cholecystectomy in form of a check list was initially established in 2008 and evaluated during a 6-month period (August 2011 until January 2012) at the University of Tuebingen. The integrated clinical pathway was evaluated during a 6-month period after an introduction phase of 2 months (November 2012 until April 2013). The contents of both clinical pathways were identical, especially concerning the standardization of perioperative fluid management, perioperative monitoring, nutrition, analgesia, reserve medications, preoperative and postoperative examinations, detailed laboratory blood testing, nursing standards and planned discharge. Primary outcome measure was the compliance to the clinical pathway defined as an adherence of more than 80% to the presetted pathway items.
Interventions
OTHERclinical pathway
implementation of a standardized clinical pathway
Sponsors
University Hospital Tuebingen
Study design
Observational model
CASE_CONTROL
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* patients undergoing elective laparoscopic cholecystectomy
Exclusion criteria
* emergency procedures * conversion to open cholecystectomy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| compliance to clinical pathway | time period which is covered by the clinical pathway beginning from preclinical check up until final discharge after cholecystctomy (usually a time frame of 7-14 days) | Compliance to clinical pathway defined as an adherence of more than 80% to the presetted pathway items as reported on a paper based check-list |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| complication | 30 days complication rate | Complications assessed according to Clavien classification 30 days postoperative |
| total cost | total cost of the hospitalization covering the period from preclinical check up until final discharge after cholecystctomy (usually a time frame of 7-14 days) | total costs per case covering the period from preclinical check up until final and discharge after cholecystctomy (€) were assessed using our prospective. electronic patient and quality assessment data base. Costs were calculated according to our internal transfer prices. |
Outcome results
None listed